Substantial Need for Preexposure Prophylaxis Among Men Who Have Sex With Men in Hanoi, Vietnam

We used data from the Health in Men—Hanoi cohort to determine the proportion of HIV-negative men who have sex with men with PrEP indications in Hanoi. Among 717 men who have sex with men, 537 (72.2% [66.6%–77.3%]) had ≥1 PrEP indication, signaling a substantial need for PrEP scale-up. Condomless anal intercoursewas themost frequent indication (68.7% [60.3%–76.1%]), followed by previous/current sexually transmitted infection (59.4% [51.0%–67.2%]). T here were an estimated 230,000 people living with HIV in Vietnam in 2019; Hanoi represents the city with the second largest burden of disease, accounting for 11% of cases (unpublished data). Vietnam’s epidemic has been historically concentrated in people who inject drugs and later female sex workers; however, recent data suggest increasing new infections among men who have sex with men (MSM). Availability of highly effective HIV prevention methods like preexposure prophylaxis (PrEP) remains limited for MSM in Vietnam. Preexposure prophylaxis, which has demonstrated up to 92% efficacy for HIV prevention among MSM, was first used in pilot studies in 2017 in Vietnam. With international donor support, public availability of PrEP began in mid-2019 in high-burden provinces including Hanoi. To inform PrEP programming and scale-up, we sought to determine the need for PrEP among participants enrolled in Health in Men (HIM)—Hanoi, a longitudinal observational cohort of MSM in Hanoi, Vietnam. MATERIALS AND METHODS The HIM-Hanoi study was established in 2017 with the major objectives of describing HIV prevalence, incidence, and associated risk factors in MSM in Hanoi. Eligibility criteria were the following: (1) Vietnamese national, (2) male sex at birth, (3) oral or anal sex with another male in the last 12 months, (4) age From the *Centers for Disease Control and Prevention; †Hanoi Medical University, Hanoi, Vietnam; ‡Australian Research Center in Sex, Health and Society, La Trobe University, Melbourne, Australia; and §University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam Conflict of Interest and Sources of Funding: The authors have no conflicts of interest to report. This research publication has been supported by the President’s Emergency Plan for AIDS Relief through the Centers for Disease Control and Prevention under the terms of GH002150. Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the funding agencies. Correspondence: Ramona Bhatia, MD, 2 Ngo Quyen St, Hanoi, Vietnam. E‐mail: nxa9@cdc.gov. Received for publication June 23, 2020, and accepted August 11, 2020. DOI: 10.1097/OLQ.0000000000001270 Copyright © 2020 American Sexually Transmitted Diseases Association. All rights reserved.