Grindr survey reveals many gay men using PrEP without doctor support

An online survey using the social dating app, Grindr, reveals that the majority of gay and other men who have sex with men (sometimes referred to as MSM) in Switzerland are considering taking pre-exposure prophylaxis (PrEP) in the future – but of those currently on PrEP, healthcare engagement is low.

The results show that a Swiss national PrEP programme is needed to ensure those who want the life-saving treatment, can access it and ensure that this is done under the supervision of professional healthcare workers.

PrEP, a course of antiretroviral treatment to prevent HIV among HIV-negative people, is currently not approved for use in Switzerland. But people can still buy the generic form of the drug, FTC/TDF, more commonly known by the brand name Truvada, in pharmacies and online.

The Federal Commission for Sexual Health, a parliamentary advisory group, do have guidelines for Swiss health professionals, should they need to monitor patients on PrEP. Despite it not yet being offered as part of a national health programme, they support use of PrEP for groups at a higher risk of HIV infection – such as those who are unable to negotiate condom use, those in a relationship with an HIV-positive person, and those who do not wear condoms.

The research included 1,893 gay men recruited from the Grindr app, who were asked to fill out a short ten question survey on Survey Monkey (to ensure anonymity). The questions centred on whether they had previously heard of PrEP; if they were accessing it, how they were using it and where they got it from; their HIV testing history; and if they weren’t on PrEP, whether they’d like access to it.

With just under half of all new HIV infections in Switzerland among gay men – finding novel ways to gather information to target this group with messaging is vital for an effective HIV response. In this instance, the use of a social media dating app was incredibly useful in collecting information to inform public health decisions.

Some 80% (1,510) of respondents had heard of PrEP before, but only 4.3% (82) were currently on it. Of these, around half had bought the treatment from a pharmacy, while the other half had bought it online. Around 78% were taking PrEP under the supervision of a healthcare professional. While the majority of those on PrEP had taken an HIV test in the last 12 months – 9% of PrEP users indicated that they had not had one in over a year. Nearly a third of all respondents (30.4%) said that their last HIV test was over a year ago.

Healthcare engagement while on PrEP is vital,  to ensure that there are no adverse drug interactions, but also to ensure that patients have regular HIV testing, and testing for other sexually transmitted infections, which PrEP does not protect against.

If PrEP is not adhered to exactly as prescribed, HIV infection can occur, and if this happens while a person is sub-optimally taking PrEP, it can result in HIV drug resistance and complicate future HIV treatment.

Of the respondents, 49.9% (944) said they were considering taking PrEP in the next six months, and 77.9% (1,474) were considering taking it at some point in the future. This, coupled with the high percentage of PrEP users not under doctor supervision, show that PrEP has huge potential as a prevention tool in Switzerland, and should be included as part of a combination prevention approach to slowing the HIV epidemic.