Gay men show higher rates of PrEP awareness and use than bisexual men

This meta-analysis evaluated the prevalence of biomedical HIV prevention strategies among a large population of 514,543 bisexual and gay men. The study specifically examined several key metrics: PrEP awareness, PrEP intention, PrEP use (categorized as any, lifetime, and current), and U = U knowledge. The primary objective was to compare the implementation of these biomedical strategies between gay and bisexual cohorts to identify disparities in prevention engagement.

The analysis compared gay men to bisexual men across multiple dimensions of HIV prevention. For the primary outcomes related to PrEP awareness, the data showed 61.4% for gay men versus 42.9% for bisexual men. Regarding any PrEP use, the prevalence was 22.5% in gay men and 15.2% in bisexual men. Lifetime PrEP use was reported at 21.5% for gay men compared to 11.9% for bisexual men. Current PrEP use was recorded at 20.9% for gay men and 16.0% for bisexual men. Additionally, U = U knowledge was higher in gay men (76.3%) than in bisexual men (69.3%).

In terms of effect sizes, the meta-analysis reported an Odds Ratio (OR) of 1.52 to 2.77 across several metrics including PrEP awareness, any PrEP use, lifetime PrEP use, current PrEP use, and U = U knowledge. These results indicate a consistently higher prevalence of these biomedical prevention markers among the gay male population compared to the bisexual male population. However, for the secondary outcome of PrEP intention, the data showed 55.6% for gay men and 56.7% for bisexual men, indicating no significant difference between the two groups in terms of their intent to use PrEP.

Safety and tolerability data were not reported in the source material, as the study focused on prevalence and awareness rather than clinical adverse events or treatment discontinuation rates. The findings are based on a large sample size of 514,543 individuals, providing a robust look at population-level disparities. However, because this is a meta-analysis of observational data, it identifies associations in prevalence rather than establishing a causal link between gender identity and uptake.

These results highlight significant gaps in the reach of HIV prevention programs for bisexual men. While both groups express similar intentions to use PrEP, the actual implementation—including awareness and current usage—is notably lower among bisexual men. This suggests that while the desire for protection exists across both demographics, the pathways to obtaining and maintaining PrEP may be less accessible or less effectively communicated to bisexual men.

The findings suggest a need for targeted interventions specifically designed for bisexual men. Clinicians and public health officials should consider more tailored policies and strategies to increase awareness and facilitate access to biomedical prevention tools for this specific population. Future research is needed to identify the specific barriers preventing bisexual men from translating their intention into actual PrEP use, as well as the factors contributing to higher awareness levels in the gay male population.