{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:45:26Z","timestamp":1787028326352,"version":"build-2736575974"},"reference-count":42,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,4,29]],"date-time":"2021-04-29T00:00:00Z","timestamp":1619654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Pre-exposure prophylaxis (PrEP) is suitable for high human immunodeficiency virus (HIV)-infection risk people, foremost among whom are males who have sex with other males (MSM). This study evaluated knowledge, attitudes and practices regarding PrEP in a sample of Italian MSM, in order to hypothesize strategies to implement PrEP awareness and use. No previous study has assessed this issue; Methods: An online survey was given to an opportunistic sample of Italian MSM. The questionnaire investigated sexual behaviour and habits, HIV\/acquired immune deficiency syndrome (AIDS) knowledge and PrEP awareness, attitudes and practices. Univariable and multivariable logistic regressions were conducted to identify factors associated with PrEP knowledge; Results: A total of 196 MSM participated in this survey. Overall data showed that 87.2% of participants knew what PrEP is, but only 7.5% have ever used it. The main reason for not using PrEP was the cost of the therapy (26.9%). The principal source of PrEP information was the Internet (68.4%). Being regularly tested for HIV was significantly associated with PrEP knowledge (adjusted odds ratio (AdjOR) = 3.16; confidence interval (CI) = 1.06\u20139.29); Conclusions: Knowledge regarding PrEP was well established, but PrEP use was not equally widespread. It is necessary to improve research on PrEP usage in order to PrEP access to be granted.<\/jats:p>","DOI":"10.3390\/ijerph18094772","type":"journal-article","created":{"date-parts":[[2021,4,30]],"date-time":"2021-04-30T05:10:55Z","timestamp":1619759455000},"page":"4772","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Knowledge, Attitudes and Practices Regarding Pre-Exposure Prophylaxis (PrEP) in a Sample of Italian Men Who Have SEX with MEN (MSM)"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5516-3419","authenticated-orcid":false,"given":"Gianluca","family":"Voglino","sequence":"first","affiliation":[{"name":"Department of Public Health Sciences and Paediatrics, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Rosaria","family":"Gualano","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences and Paediatrics, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4586-7209","authenticated-orcid":false,"given":"Stefano","family":"Rousset","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences and Paediatrics, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Forghieri","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences and Paediatrics, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Fraire","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences and Paediatrics, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Bert","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences and Paediatrics, University of Turin, 10126 Turin, Italy"},{"name":"AOU City of Health and Science of Turin, Corso Bramante 88, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Siliquini","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences and Paediatrics, University of Turin, 10126 Turin, Italy"},{"name":"AOU City of Health and Science of Turin, Corso Bramante 88, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,29]]},"reference":[{"key":"ref_1","unstructured":"Istituto Superiore di Sanit\u00e0 (2021, April 27). Aggiornamento delle Nuove Diagnosi di Infezione da HIV e dei casi di AIDS in Italia al 31 Dicembre 2017, Available online: http:\/\/www.salute.gov.it\/imgs\/C_17_pubblicazioni_2661_allegato.pdf."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e38","DOI":"10.1097\/JNC.0000000000000105","article-title":"Pre-Exposure Prophylaxis Use and Medication Adherence Among Men Who Have Sex with Men: A Systematic Review of the Literature","volume":"30","author":"Maxwell","year":"2019","journal-title":"J Assoc. Nurses AIDS Care"},{"key":"ref_3","unstructured":"Ministero Della Salute, and Societ\u00e0 Italiana di Malattie Infettive e Tropicali (2017). Linee Guida Italiane Sull\u2019utilizzo Della Terapia Antiretrovirale e la Gestione Diagnostico-Clinica Delle Persone con Infezione da HIV-1. Archives, 1\u20133. Available online: http:\/\/www.salute.gov.it\/imgs\/C_17_pubblicazioni_2696_allegato.pdf."},{"key":"ref_4","unstructured":"Ministero Della Salute (2021, April 27). Come Prevenire l\u2019AIDS, Available online: http:\/\/www.salute.gov.it\/portale\/hiv\/dettaglioContenutiHIV.jsp?lingua=italiano&id=5209&area=aids&menu=vuoto."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1973","DOI":"10.1097\/QAD.0000000000001145","article-title":"Effectiveness and safety of oral HIV preexposure prophylaxis for all populations","volume":"30","author":"Fonner","year":"2016","journal-title":"Aids"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.medmal.2018.01.009","article-title":"HIV preexposure prophylaxis: An essential, safe and effective prevention tool for sexual health","volume":"48","author":"Siguier","year":"2018","journal-title":"Med. Mal. Infect."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1080\/14740338.2016.1211108","article-title":"Drug safety evaluation of oral tenofovir disoproxil fumarate-emtricitabine for pre-exposure prophylaxis for human immunodeficiency virus infection","volume":"15","author":"Trang","year":"2016","journal-title":"Expert Opin. Drug Saf."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/S0140-6736(15)00056-2","article-title":"Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): Effectiveness results from the pilot phase of a pragmatic open-label randomised trial","volume":"387","author":"McCormack","year":"2016","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2237","DOI":"10.1056\/NEJMoa1506273","article-title":"ANRS IPERGAY Study Group. Ondemand preexposure prophylaxis in men at high risk for HIV-1 infection","volume":"23","author":"Molina","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_10","unstructured":"WHO (2017). WHO Implementation Tool for Pre-Exposure Prophylaxis (PrEP) of HIV Infection. Module 1: Clinical, World Health Organization. Available online: https:\/\/www.who.int\/hiv\/pub\/prep\/prep-supplement-jias-2015\/en\/."},{"key":"ref_11","unstructured":"Ministero Della Salute\u2014Direzione Generale Della Prevenzione Sanitaria (2021, April 27). Piano Nazionale Della Prevenzione 2020\u20132025. Available online: http:\/\/www.ccm-network.it\/documenti_Ccm\/Prp\/LAZIO\/Piani_Lazio\/Lazio_incidenti_stradali.pdf."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Iniesta, C., \u00c1lvarez-del Arco, D., Garc\u00eda-Sousa, L.M., Alejos, B., D\u00edaz, A., Sanz, N., Garrido, J., Meulbroek, M., Pujol, F., and Moreno, S. (2018). Awareness, knowledge, use, willingness to use and need of Pre-Exposure Prophylaxis (PrEP) during World Gay Pride 2017. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0204738"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2587","DOI":"10.1056\/NEJMoa1011205","article-title":"Preexposure chemoprophylaxis for HIV prevention in men who have sex with men","volume":"363","author":"Grant","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"21580","DOI":"10.7448\/IAS.20.1.21580","article-title":"Awareness and willingness to use HIV pre-exposure prophylaxis among men who have sex with men in low- and middle-income countries: A systematic review and meta-analysis","volume":"20","author":"Yi","year":"2017","journal-title":"J. Int. AIDS Soc."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Palummieri, A., De Carli, G., Rosenthal, \u00c9., Cacoub, P., Mussini, C., and Puro, V. (2017). Awareness, discussion and non-prescribed use of HIV pre-exposure prophylaxis among persons living with HIV\/AIDS in Italy: A Nationwide, cross-sectional study among patients on antiretrovirals and their treating HIV physicians. BMC Infect. Dis., 17.","DOI":"10.1186\/s12879-017-2819-5"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1177\/109019818801500203","article-title":"Social learning theory and the Health Belief Model","volume":"15","author":"Rosenstock","year":"1988","journal-title":"Health Educ. Q."},{"key":"ref_17","first-page":"32","article-title":"Designing a Questionnaire","volume":"1","author":"Jenn","year":"2006","journal-title":"Malays. Fam. Physician"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1007\/s10461-006-9135-1","article-title":"Intentional unprotected anal intercourse among sex who have sex with men: Barebacking-from behavior to identity","volume":"11","author":"Parsons","year":"2007","journal-title":"AIDS Behav."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"874","DOI":"10.15585\/mmwr.mm6840a2","article-title":"National Latinx AIDS Awareness Trends in Sexual Risk Behaviors Among Hispanic\/Latino Men Who Have Sex with Men\u201419 Urban Areas, 2011\u20132017","volume":"68","author":"Trujillo","year":"2019","journal-title":"MMWR Morb. Mortal. Wkly Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1007\/s10461-006-9168-5","article-title":"Development and psychometric evaluation of a self-administered questionnaire to measure knowledge of sexually transmitted diseases","volume":"11","author":"Jaworski","year":"2007","journal-title":"AIDS Behav."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1007\/s10461-016-1407-9","article-title":"Attitudes Toward HIV Pre-Exposure Prophylaxis in a United States Urban Clinic Population","volume":"20","author":"Kwakwa","year":"2016","journal-title":"AIDS Behav."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"j5011","DOI":"10.1136\/bmj.j5011","article-title":"State of the art review: Recent advances in pre-exposure prophylaxis for HIV","volume":"359","author":"Desai","year":"2017","journal-title":"BMJ"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1632","DOI":"10.2307\/2532419","article-title":"Applied Logistic Regression","volume":"47","author":"Scott","year":"1991","journal-title":"Biometrics"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Wagenaar, B.H., Sullivan, P.S., and Stephenson, R. (2012). HIV knowledge and associated factors among internet-using men who have sex with men (MSM) in south africa and the united states. PLoS ONE, 7.","DOI":"10.1371\/annotation\/7910bc43-9371-4ad5-aa5d-900161daf089"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1071\/SH18032","article-title":"HIV knowledge, sexual health and sexual behaviour among Black and minority ethnic men who have sex with men in the UK: A cross-sectional study","volume":"16","author":"Jaspal","year":"2019","journal-title":"Sex. Health"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e190005","DOI":"10.1590\/1980-549720190005.supl.1","article-title":"HIV\/AIDS knowledge among MSM in Brazil: A challenge for public policies","volume":"22","author":"Magno","year":"2019","journal-title":"Rev. Bras. Epidemiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1097\/QAI.0b013e3181baf111","article-title":"Estimating levels of HIV testing, HIV prevention coverage, HIV knowledge, and condom use among men who have sex with men (MSM) in low-income and middle-income countries","volume":"52","author":"Adam","year":"2009","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1080\/09540121003692193","article-title":"Influence of religious affiliation and education on HIV knowledge and HIV-related sexual behaviors among unmarried youth in rural central Mozambique","volume":"22","author":"Noden","year":"2010","journal-title":"AIDS Care Psychol. Socio Med Asp"},{"key":"ref_29","unstructured":"UNICEF (2021, April 27). Girls, HIV\/AIDS and Education. Available online: https:\/\/www.unicef.org\/publications\/files\/Girls_HIV_AIDS_and_Education_(English)_rev.pdf."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/S0140-6736(12)60821-6","article-title":"Global epidemiology of HIV infection in men who have sex with men","volume":"380","author":"Beyrer","year":"2012","journal-title":"Lancet"},{"key":"ref_31","unstructured":"Corbelli, P.G.S.G.M., Mattioli, S., and Esposti, M.D. (2015, January 17\u201319). Would you use PrEP? Trends among MSM between 2013 and 2015. Proceedings of the Italian Conference on AIDS and Retrovirus, Rome, Italy."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Lim, S.H., Mburu, G., Bourne, A., Pang, J., Wickersham, J.A., Wei, C.K.T., Yee, I.A., Wang, B., Cassolato, M., and Azwa, I. (2017). Willingness to use pre-exposure prophylaxis for HIV prevention among men who have sex with men in Malaysia: Findings from an online survey. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0182838"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"19734","DOI":"10.7448\/IAS.17.4.19734","article-title":"Acceptability of PrEP among HIV negative Portuguese men who have sex with men that attended 2014 Lisbon pride fair","volume":"17","author":"Brito","year":"2014","journal-title":"J. Int. AIDS Soc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1097\/QAD.0000000000000639","article-title":"What do Dutch MSM think of preexposure prophylaxis to prevent HIV-infection? A cross-sectional study","volume":"29","author":"Bil","year":"2015","journal-title":"Aids"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1080\/09540121.2013.803014","article-title":"Preexposure prophylaxis (PrEP) of HIV infection in France: A nationwide cross-sectional study (PREVIC study)","volume":"26","author":"Rosenthal","year":"2014","journal-title":"AIDS Care"},{"key":"ref_36","unstructured":"European Medicines Agency (2016). First Medicine for HIV Pre-Exposure Prophylaxis Recommended for Approval in the EU."},{"key":"ref_37","unstructured":"AVAC (2021, April 27). Global Advocy for HIV Prevention. Available online: https:\/\/www.prepwatch.org."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Di Biagio, A., Riccardi, N., Signori, A., Maserati, R., Nozza, S., Gori, A., Bonora, S., Borderi, M., Ripamonti, D., and Rossi, M.C. (2017). PrEP in Italy: The time may be ripe but who\u2019s paying the bill? A nationwide survey on physicians\u2019 attitudes towards using antiretrovirals to prevent HIV infection. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0181433"},{"key":"ref_39","first-page":"1","article-title":"Emtricitabine-tenofovir exposure and pre-exposure efficacy in men who have sex with men","volume":"4","author":"Anderson","year":"2012","journal-title":"Sci. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1001\/jama.2018.1917","article-title":"HIV preexposure prophylaxis: A review","volume":"319","author":"Riddell","year":"2018","journal-title":"JAMA J. Am. Med. Assoc."},{"key":"ref_41","first-page":"1900693","article-title":"Current experiences of accessing and using HIV pre-exposure prophylaxis (PrEP) in the United Kingdom: A cross-sectional online survey, May to July 2019","volume":"24","author":"Owen","year":"2019","journal-title":"Eurosurveillance"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Prati, G., Zani, B., Pietrantoni, L., Scudiero, D., Perone, P., Cosmaro, L., Cerioli, A., and Oldrini, M. (2016). Pep and tasp awareness among Italian msm, plwha, and high-risk heterosexuals and demographic, behavioral, and social correlates. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0157339"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/9\/4772\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:55:44Z","timestamp":1760162144000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/9\/4772"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,29]]},"references-count":42,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,5]]}},"alternative-id":["ijerph18094772"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18094772","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,29]]}}}