Pre-exposure prophylaxis engagement among sexual minority men in Taiwan: a behavioral health perspective

In Taiwan, sexual minority men (SMM) account for a significant portion of new HIV cases, highlighting the need for effective prevention measures. However, pre-exposure prophylaxis (PrEP) use remains limited, necessitating a comprehensive examination of barriers. This study examined PrEP engagement and its predictors among 284 SMM in Taiwan. Participants were categorized into five stages, based on the Transtheoretical Model of Health Behavior Change, reflecting distinct levels of PrEP engagement. Ordinal logistic regression, informed by the Behavioral Model of Health Service Use, identified factors associated with being positioned at higher stages of the cascade. Significant predictors of PrEP engagement included predisposing (i.e., relationship status), enabling (i.e., PrEP knowledge, community connectedness), and need factors (i.e., number of sexual partners, chemsex). Findings highlight the need for further research on education, relationship dynamics, and sexual risk behaviors to inform tailored interventions that enhance PrEP engagement among SMM in Taiwan and the broader Asia region.