# Attitudes of Men Who Have Sex With Men Toward HIV Functional Cure: Community-Based Study

## TL;DR

This study explores how men who have sex with men in Hong Kong without HIV perceive the idea of a functional HIV cure and their willingness to participate in related clinical trials.

## Contribution

The study provides new insights into the attitudes of HIV-negative MSM toward functional cure and identifies distinct groups based on their beliefs and behaviors.

## Key findings

- About 43% of HIV-negative MSM in Hong Kong were aware of the concept of a functional HIV cure.
- Trial participation willingness was high (84%) and linked to higher-risk sexual behavior indicators.
- Four distinct groups of MSM were identified based on their attitudes and beliefs about functional cure.

## Abstract

Investigation of community awareness of HIV functional cure has often been restricted to people living with HIV. An understanding of the attitudes of men who have sex with men (MSM) without HIV is important, as it contributes to the supportiveness of curative treatment in the community.

This study aimed to profile the attitudes toward HIV functional cure among MSM without HIV.

This is a secondary analysis of data from a community-based survey on MSM 18 years or older in Hong Kong. MSM who self-reported being HIV negative were recruited for enrollment in the study. To understand the diversity of beliefs and their association with attitudes toward functional cure, attributes under the health belief model constructs were used for delineation of the study population by latent class analysis. Factors, including identified latent class analysis, associated with each outcome variable, including awareness, high anticipation, and trial participation willingness, were examined in bivariable and multivariable logistic regression models.

A total of 712 MSM were recruited between September 2021 and October 2022, a majority of whom were Chinese, single, and employed. In 541 (76%) MSM who self-reported not having tested positive for HIV, 43% (n=233) were aware of and 44% (n=236) held high anticipation toward functional cure, while 84% (n=452) indicated willingness to join clinical trials. Trial participation willingness and high anticipation were associated with indicators of higher risk sexual behavior. Four latent classes were identified. Compared with the reference group of class 4 (considered nontransmissibility as the main benefit, n=301, 56%), MSM in class 1 (selection of all perceived benefits, n=40, 7%) and class 2 (considered safety, trial duration, sites as most important, n=82, 15%) had significantly higher anticipation of functional cure, while those from class 2 were less likely to be aware of functional cure, and those from class 3 (no selection of reasons for joining trials, n=118, 22%) were less willing to participate in a trial.

In Hong Kong, compared with MSM living with HIV, MSM without HIV had similar awareness and trial participation willingness but lower anticipation of functional cure, probably due to lower susceptibility to HIV infection. As community awareness and understanding of the functional cure concept take time to nourish, these have to be nurtured in advance while the development of the functional cure is in progress.