Profiling the HIV Pre-exposure Prophylaxis (PrEP) Cascade in Japan: A Latent Class Analysis of a Nationwide Cross-Sectional Study.

To understand opportunities for improving pre-exposure prophylaxis (PrEP) uptake, this study constructed a PrEP cascade and examined subgroup profiles associated with transitions along the cascade among gay, bisexual, and other men who have sex with men (gbMSM) in Japan. An online cross-sectional su...

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Publicado en:AIDS & Behavior Vol. 30; no. 1; pp. 142 - 151
Autores principales: Miwa, Takeshi, Strong, Carol, Ku, Stephane Wen-Wei, Li, Chia-Wen, Huang, Poyao, Wu, Huei-Jiuan, Yamaguchi, Masazumi, Ikushima, Yuzuru
Formato: research tables/charts Journal Article
Publicado: Springer Nature Jan2026
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Profiling the HIV Pre-exposure Prophylaxis (PrEP) Cascade in Japan: A Latent Class Analysis of a Nationwide Cross-Sectional Study.
      aug:
        au:
          Miwa, Takeshi
          Strong, Carol
          Ku, Stephane Wen-Wei
          Li, Chia-Wen
          Huang, Poyao
          Wu, Huei-Jiuan
          Yamaguchi, Masazumi
          Ikushima, Yuzuru
        affil: https://ror.org/01b8kcc49 Department of Public Health, College of Medicine, National Cheng Kung University, 8F-8068, No. 138, ShengLi Rd., North Dist., 704, Tainan, Taiwan
      sug:
        subj:
          HIV Infections Prevention and Control
          Pre-Exposure Prophylaxis
          Gay Persons
          Bisexual Persons
          Men Who Have Sex With Men
          Human
          Japan
          Female
          Male
          Adult
          Cross Sectional Studies
          Surveys
          Sociodemographic Factors
          Gender Identity
          Sexual Orientation
          Geographic Factors
          Sexual Behavior
          Condoms
          Maximum Likelihood
          Logistic Regression
          Structural Equation Modeling
          Data Analysis Software
          Descriptive Statistics
          Funding Source
          Adult: 19-44 years
          Female
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      ab: To understand opportunities for improving pre-exposure prophylaxis (PrEP) uptake, this study constructed a PrEP cascade and examined subgroup profiles associated with transitions along the cascade among gay, bisexual, and other men who have sex with men (gbMSM) in Japan. An online cross-sectional survey was conducted from February to March 2021. The four-step PrEP cascade included awareness, willingness, initiation, and regimen use. Latent class analysis (LCA) identified participant subgroups, and logistic regression examined associations with the most significant drop-off in the cascade. Among 5,831 cisgender gbMSM not living with HIV (median age: 38 years), 52.6% were aware of PrEP, 76.4% of whom were willing to use it. However, only 20.5% of those willing had initiated PrEP—the largest decline in the cascade. Among those who initiated, 43.8% were on a daily regimen. LCA identified four subgroups: (i) Sexual Adventurers (32.1%)—high sexual activity and strong HIV community ties; (ii) Reserved Bystanders (26.7%)—low engagement with the HIV community and sexual health services; (iii) Positive Allies (24.6%)—strong HIV community ties and comfort discussing sexual health; and (iv) Young Explorers (16.7%)—younger, moderately sexually active, with limited HIV community ties. Compared to Reserved Bystanders, Sexual Adventurers (OR 5.27, 95% CI 3.91–7.10) and Positive Allies (OR 1.60, 95% CI 1.14–2.26) had significantly higher odds of PrEP initiation. Despite increasing acceptability, barriers to PrEP uptake persist. Targeted interventions are needed to address subgroup-specific challenges—particularly for younger gbMSM and those with limited access to HIV community networks and sexual health services.
      pubtype: Academic Journal
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      ougenre: Article
    language: English
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