Gay and bisexual men who use HIV prevention pill PrEP have lower anxiety

A new study from the Kirby Institute at UNSW Sydney published today shows that gay and bisexual men who are taking the HIV prevention medication PrEP (pre-exposure prophylaxis) also have significantly lower levels of HIV-related anxiety.

HIV transmission anxiety has affected sexual behaviors of gay and bisexual men for more than 30 years, but this new research provides the strongest evidence globally to suggest that alongside driving down HIV infection rates, PrEP may be enhancing the mental health and wellbeing of gay and bisexual men.

PrEP was made available in Australia through the Pharmaceutical Benefits Scheme in April 2018. When taken as directed, the medication prevents an HIV negative person from acquiring HIV.

Phillip Keen from the Kirby Institute, co-lead author on the paper, said this research has important implications for our understanding of the benefits of PrEP. "We've known for some time that PrEP is very good at protecting people from HIV. This new evidence suggests that another benefit of taking PrEP is improved mental health, through reduced anxiety about HIV," said Mr Keen.

The researchers analyzed data from the Following Lives Undergoing Change study, a national, online survey of the sexual and drug use behaviors of more than 2,500 gay and bisexual men in Australia in 2018.

"Among men who are eligible for the HIV prevention medication, we found that levels of anxiety were significantly lower among those men who were using PrEP, compared to those who were not taking it," said senior researcher Mohamed A. Hammoud from the Kirby Institute, who was also co-lead author of the paper.

In Australia, PrEP can be prescribed by general practitioners to people at risk of HIV infection, but according to a 2018 study, less than half of people at high risk for HIV are currently taking the medication. "These findings about reduced anxiety should inform how PrEP is promoted to gay and bisexual men and could be used to support higher PrEP use in Australia," said Mr Hammoud.

The Australian Federation of AIDS Organisations (AFAO) commented that this research represents a turning point in our understanding of how fear of HIV has influenced sexual relationships for many gay and bisexual men.

"PrEP has provided many gay and bisexual men with a highly effective strategy to prevent HIV transmission. It has helped many gay men enjoy sex without being fearful of HIV," said AFAO CEO, Adj A/Prof Darryl O'Donnell.