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Absolute risk framing increases interest in PrEP by 13.8% compared to relative termsUsing absolute numbers to explain HIV risk may increase interest in prevention

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Key Takeaway
Consider using absolute risk framing to potentially increase interest in PrEP among GBM populations.

This randomized survey evaluated the impact of communication framing on PrEP interest among 461 non-PrEP using gay, bisexual, and other men who have sex with men (GBM) in Canada. The study compared HIV risk messages framed in absolute terms (e.g., Your risk is XX%) against those framed in relative terms (e.g., Your risk is XX times that of other GBM).

The primary outcome was increased interest in PrEP. Results showed higher interest in the absolute group compared to the relative group, with 56.9% vs 43.1% respectively (difference=13.8%, p=0.071). When adjusted for clinical indication, the absolute group showed an AOR of 1.74 (95%CI:0.86-3.59). When adjusted for prior PrEP use, the absolute group showed an AOR of 1.49 (95%CI:0.95-2.35).

Safety and tolerability data were not reported. A key limitation was that results in multivariable models for clinical indication and prior PrEP use were not statistically significant. While absolute framing may encourage interest, clinicians should note that addressing stigma and structural barriers remains essential.

How this fits prior evidence

This finding addresses a gap in understanding how communication styles influence PrEP engagement. It builds upon previous evidence showing that gay men have higher rates of PrEP awareness and use than bisexual men. However, it does not directly address the findings regarding peer referral's impact on testing or the role of group support models for adolescent girls and young women.

Doctors often talk about health risks using comparisons. For example, they might say a person is twice as likely to get sick compared to someone else. This study looked at whether giving a direct percentage—like saying there is a 1% chance of infection—works better than using these types of comparisons.

Researchers surveyed over 400 men who have sex with men in Canada. They wanted to see which way of explaining risk made people more interested in taking PrEP, which is a medicine used to prevent HIV. The results showed that when the risk was shared as a direct percentage, more people expressed interest in starting the medication.

While the study showed a positive trend for using absolute numbers, some of the data did not reach the highest level of statistical certainty. However, the findings suggest that clear and direct communication can be a helpful tool for healthcare providers. Providing simple facts may help patients make better decisions about their health.

What this means for you:
Sharing HIV risk as a direct percentage may increase interest in prevention medicine more than using comparisons.

Common questions

What is PrEP?

PrEP stands for pre-exposure prophylaxis. It is a medication that people who are not currently living with HIV can take to lower their risk of getting infected from sexual contact.

How did the way information was shared affect interest in PrEP?

People who were told their risk in absolute terms, such as a specific percentage, showed more interest in PrEP than those who heard their risk compared to others. The study found 56.9% of the absolute group showed interest versus 43.1% of the relative group.

Was the finding that absolute numbers work certain?

The results were promising, but some parts were not statistically significant when researchers adjusted for things like prior PrEP use or specific clinical reasons. This means the evidence is still developing and more research may be needed.

Study Details

Study typeRct
Sample sizen = 461
EvidenceLevel 2
PublishedAug 2026
View Original Abstract ↓
The way human immunodeficiency virus (HIV) acquisition risk is communicated can shape individuals' perceptions and their interest in using pre-exposure prophylaxis (PrEP). This study examined two risk communication strategies among non-PrEP-using gay, bisexual, and other men who have sex with men (GBM) in Canada. In 2022, adult GBMs in Ontario and British Columbia completed an online survey and were randomly assigned to receive HIV risk messages tailored to their risk assessment scores. Messages were framed in either absolute terms ("Your risk is XX%") or relative terms ("Your risk is XX times that of other GBM"). Participants compared this with their self-rated HIV risk and indicated whether it increased their interest in PrEP. Logistic regression models were applied to analyze the data. Among 461 participants, 64.2% perceived themselves as low risk and 51.0% met clinical indications for PrEP. Of 428 participants, 56.9% in the "absolute" group versus 43.1% in the "relative" group reported increased PrEP interest (difference=13.8%, =0.071). In multivariable analyses, absolute risk message framing was associated with higher, though non-significant, PrEP interest in the model adjusted for clinical indication (AOR:1.74, 95%CI:0.86-3.59) and in the model adjusted for prior PrEP use (AOR:1.49, 95%CI:0.95-2.35). These findings suggest that individualized risk framing in absolute terms may encourage PrEP interest, but addressing PrEP stigma and structural barriers such as cost remains essential to expand PrEP use.
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