PrEP-Related Perceptions Associated With Willingness to Use LAI-PrEP Among a National Sample of Chinese MSM.

This cross-sectional study investigated long-acting injectable pre-exposure prophylaxis (LAI-PrEP) perceptions and attitudes among 1,545 Chinese men who have sex with men (MSM) in December 2023. Of participants, 66.5% met PrEP eligibility criteria, 53.7% expressed willingness to use LAI-PrEP within 6 months, and 77.9% were PrEP naïve. Current oral PrEP users showed higher LAI-PrEP willingness (adjusted odds ratio [AOR] = 2.23, 95% CI [1.44, 3.44]) than the PrEP naïve group. Condomless anal intercourse (AOR = 1.32, 95% CI [1.08, 1.61]) and recent sexually transmitted infection diagnosis (AOR = 1.84, 95% CI [1.15, 2.95]) were positively associated with willingness. Structural equation modeling revealed distinct predictors: for PrEP naïve group, LAI-PrEP willingness was influenced by outcome expectancies, HIV risk perception, self-efficacy, and subjective norms (p <.05), while the PrEP-experienced group relied more on outcome expectancies. Tailored interventions addressing group-specific cognitive factors are critical to optimize LAI-PrEP adoption.