(P303) Newly diagnosed HIV and use of HIV-PrEP among migrant MSM attending STI clinics in the Netherlands, a retrospective cohort study

Introduction: The World Health Organization recommends HIV-PrEP for all people at substantial risk for HIV infection. Of MSM diagnosed with HIV in the Netherlands, almost half were born abroad. Two-third reported HIV acquisition after arrival, which underpins the importance of HIV-PrEP accessibility for migrant MSM at risk of HIV exposure. To gain insight in current PrEP use and options for tailoring PrEP information to migrant MSM, this study assessed demographic factors related to HIV and PrEP use among first-generation migrant MSM (FGM-MSM).

Methods: Surveillance data of consultations among MSM in all Dutch STI clinics (from 2016 to 2021) were analysed. STI clinics provide PrEP care via the national pilot-program since August 2019, to MSM with a high risk for HIV. FGM-MSM were defined as born in Eastern Europe, Latin America, Asia, Africa, Netherlands Antilles or Suriname. Multivariable generalized estimating equations analyses were used to assess demographic factors related to HIV risk, and multivariable logistic regression analyses to assess factors related to recent PrEP use (past 3 months) in a person-level high risk data-subset from August 2019 (i.e. report of >2 sex partners and inconsistent condom use during anogenital sex).

Results: New HIV was diagnosed among 1.1% (493/44,394) of MSM-consultations in FGM-MSM (0.4% among western-born MSM). Proportion of new HIV diagnoses were comparable between age-groups and between areas of urbanisation. Practical education level (aOR: 2.3, 95%CI: 1.8-2.9) was associated with new HIV (versus theoretical education). Current PrEP use was 40.7% in FGM-MSM (1711/4207) (34.9% among western-born MSM). PrEP use was lower among FGM-MSM aged under 25 years (aOR: 0.3, 95%CI: 0.2-0.3), living in less urban areas (aOR: 0.7, 95%CI: 0.5-0.9), and having practical education level (aOR: 0.6, 95%CI: 0.5-0.7).

Conclusion: FGM-MSM were more often diagnosed with HIV than western-born MSM, confirming that FGM-MSM are an important key population in HIV prevention. Less than half of FGM-MSM used HIV-PrEP (use was higher than in western-born MSM). Access to HIV prevention can be further optimized to all FGM-MSM at risk for HIV, and specifically to those who are younger, live in less urban areas, and who have a practical education level.