biostudies-literatureZhao MNatural Science Foundation of Shaanxi ProvinceNational Key Research and Development Programme of ChinaHumanities and Social Science Fund of Ministry of Education of China749-767https://www.ebi.ac.uk/biostudies/studies/S-EPMC12924801biostudies-literatureUnknown15(3)<h4>Introduction</h4>Implementing pre-exposure prophylaxis (PrEP) is hindered by a significant "PrEP Cliff", a sharp decline from willingness to uptake and adherence. This study aimed to integrate status quo bias theory with a dual-process model, seeking to understand how this bias influences the PrEP cascade among men who have sex with men (MSM) in China.<h4>Methods</h4>A cross-sectional survey was conducted among 1022 MSM across six provinces in China from November 2024 to February 2025. Through regression models, we tested a moderated mediation framework to examine how status quo bias influenced PrEP willingness, uptake, and adherence, focusing on the mediating role of PrEP resistance intention and the moderating role of condom-use inertia.<h4>Results</h4>Participants were generally youInfectious diseases and therapyHow Status Quo Bias Shapes Willingness, Uptake, and Adherence to PrEP Among Chinese MSM: A Behavioral Economics Perspective.PMC129248012022YFC250510024YJC8400512022YFC23049002025JC-YBQN-1106Zhao MOng JJZhang YJi FZhang LTang WZhao XYin ZfalseHow Status Quo Bias Shapes Willingness, Uptake, and Adherence to PrEP Among Chinese MSM: A Behavioral Economics Perspective.<h4>Introduction</h4>Implementing pre-exposure prophylaxis (PrEP) is hindered by a significant "PrEP Cliff", a sharp decline from willingness to uptake and adherence. This study aimed to integrate status quo bias theory with a dual-process model, seeking to understand how this bias influences the PrEP cascade among men who have sex with men (MSM) in China.<h4>Methods</h4>A cross-sectional survey was conducted among 1022 MSM across six provinces in China from November 2024 to February 2025. Through regression models, we tested a moderated mediation framework to examine how status quo bias influenced PrEP willingness, uptake, and adherence, focusing on the mediating role of PrEP resistance intention and the moderating role of condom-use inertia.<h4>Results</h4>Participants were generally you2026-01-01T00:00:00Z2026 Mar2026-07-16T15:18:09.738Z2026-07-11T03:07:27.721ZS-EPMC129248014157570410.1007/s40121-025-01296-y