PrEParing for HIV prevention among men who have sex with men in China: challenges and solutions.

Although pre-exposure prophylaxis (PrEP) has been implemented globally, in China, engagement with the PrEP care continuum is overall low among men who have sex with men (MSM). The large population of MSM and the high proportion of PrEP-eligible individuals, coupled with low PrEP uptake and adherence, underscore the urgent need for initiatives to address barriers and facilitate uptake in this population. Based on the social ecological framework, low PrEP uptake and adherence among MSM in China can be attributed to multiple factors at the individual, interpersonal and community, and policy levels, which require a comprehensive and multifaceted approach to address. Tailored combinations of strategies need to be developed to increase PrEP awareness, acceptance, adherence, and persistence among individuals, health-care providers, and the MSM communities. Reducing stigma and discrimination towards PrEP and the MSM community is crucial to the successful implementation of PrEP. Additionally, policies that promote PrEP uptake and ensure access to appropriate regimens for eligible MSM should be in place. Solutions proposed in this Viewpoint have implications for other low-income and middle-income countries facing similar challenges against PrEP implementation.