Using Online Media to Increase the Awareness and Uptake of Preexposure Prophylaxis for HIV Among Asian-Born Men Who Have Sex With Men Living in Australia: An Open-Label Randomized Controlled Trial.

Background: HIV notifications have increased among Asian-born men who have sex with men (MSM) in Australia. However, most existing campaigns were not designed for this population. This study assessed the acceptability of using a community-based audio drama from our previous "designathon" to increase the awareness and uptake of preexposure prophylaxis (PrEP), as compared with written information on the PAN website (PrEP Access Now; PAN.org.au), among Asian-born MSM in Australia.

Methods: This open-label, 2-arm pilot trial based on a stratified randomized controlled design was conducted between April and July 2024. A total of 200 Asian-born MSM were randomized 1:1 to receive either the audio drama (intervention)-which featured a PrEP journey of an Asian-born man in the MSM community who had newly arrived in Australia-or the PrEP Access Now website (control), which is often suggested by clinicians in Victoria to gain PrEP-related information. An intention-to-treat analysis was used to evaluate the data. The primary outcomes included acceptability, attitudes toward PrEP, and intention to use PrEP. The secondary outcomes included PrEP initiation and adherence to PrEP and PrEP-related knowledge.

Results: Among the 200 participants, 96 formed the control arm, and 104 formed the intervention arm. Extreme satisfaction was expressed by 74% (71/96) and 77% (80/104) of the control and intervention arms, respectively. Full engagement (ie, completed the online media) occurred in 22% (21/96) and 85% (88/104) of the control and intervention arms ( < .001). The median score increases in having a positive attitude toward PrEP were 4 (IQR, 0-7) and 7 (IQR, 3-12.5) in the control and intervention arms ( = .023). Both online media increased the uptake of PrEP, with no significant differences observed between the arms. At the 2-month follow-up, 18% (17/96) and 22% (23/104) initiated PrEP in the control and intervention arms. The most reported reasons for not initiating PrEP were concern about side effects (20%, 19/96) in the control arm and perceived inconvenience of PrEP use (16%, 17/104) in the intervention arm. Six participants in the control arm and 4 in the intervention arm discontinued PrEP.

Conclusions: The audio drama effectively engaged Asian-born MSM and positively influenced their attitudes toward PrEP use. Strategies to link individuals to care after the audio drama are needed to increase the uptake of PrEP. Future trials should consider incorporating further support in PrEP initiation for this population.

Clinical Trials Registration: ACTRN12623001361695 (Australian New Zealand Clinical Trials Registry https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id = 387003).