Introduction:
To guide future preexposure prophylaxis (PrEP) implementation for women who inject drugs (WWID), a population increasingly represented in new HIV cases in the United States, we present results from a demonstration project integrated within a syringe services program (SSP) in Philadelphia, PA.
Methods:
WWID ≥18 years were educated about and offered 24 weeks of daily PrEP. Participants completed surveys and clinical assessments at baseline and at weeks 1, 3, 12, and 24. We used descriptive statistics to estimate feasibility/acceptability, engagement in the care cascade, HIV/sexually transmitted diseases (STI) and pregnancy, issues of safety/tolerability, and preferences/satisfaction with PrEP services. Multivariable logistic regression with generalized estimating equations was used to identify factors associated with PrEP uptake and retention.
Results:
We recruited 136 WWID. Of those, 95 were included in the final sample, and 63 accepted a PrEP prescription at week 1. Uptake was associated with greater baseline frequency of SSP access [adjusted odds ratio (aOR) = 1.85; 95% confidence interval (CI): 1.24 to 2.77], inconsistent condom use (aOR = 3.38; 95% CI: 1.07 to 10.7), and experiencing sexual assault (aOR = 5.89; 95% CI: 1.02, 33.9). Of these 95, 42 (44.2%) were retained at week 24. Retention was higher among women who reported more frequent baseline SSP access (aOR = 1.46; 95% CI: 1.04 to 2.24). Self-reported adherence was high but discordant with urine-based quantification of tenofovir. Baseline STI prevalence was 17.9%; there were 2 HIV seroconversions and 1 pregnancy. Safety/tolerability issues were uncommon, and acceptability/satisfaction was high.
Conclusions:
Integrating PrEP with SSP services is feasible and acceptable for WWID. This suggests that daily PrEP is a viable prevention tool for this vulnerable population.
Introduction:
We assessed awareness of pre-exposure prophylaxis
(PrEP) among HIV-negative Black and Latinx persons living in the Philadelphia
Metropolitan Statistical Area.
Methods:
Using chi-square and
Wilcoxon rank-sum tests, we analyzed data from the 2016 heterosexual cycle of
the National HIV Behavioral Surveillance system to assess how sociodemographic
factors, health care utilization, and risk behaviors affected PrEP awareness.
Results:
Participants (n = 472) were predominately Black,
non-Hispanic (88.1%) with a median age of 41.5 years. Most participants reported
having a usual source of medical care (92.1%) and seeing a medical provider
within 12 months (87.0%). However, PrEP awareness was low in this sample (4.9%)
and was lower among those who had a medical visit compared with those who had
not (
P
< .01).
Conclusion:
Current Centers for
Disease Control and Prevention clinical guidelines suggest that providers
counsel high-risk patients about PrEP. Our data suggest that this is not
happening with people of color in Philadelphia. Interventions targeting medical
providers working with HIV-risk people of color may be appropriate.
This study used Behavioral Model for Vulnerable Populations (BMVP) to identify factors associated with pre-exposure prophylaxis (PrEP) initiation among women who inject drugs (WWID) when PrEP was offered at a syringe services program (SSP). Participants (n = 89) were WWID, $ge18 years, and eligible for PrEP. Most (69) initiated PrEP. Chi square and t tests were used to identify bivariate relationships between BMVP factors and PrEP initiation. A greater proportion of PrEP initiators (compared to non-initiators) reported sexual assault, frequent SSP attendance, earning $ge$5,000 annually and inconsistent condom use. Findings can inform the development of gender-specific strategies to promote PrEP among WWID.
of CT and NG in different anatomic sites among Chinese MSM. Methods Participants were enrolled in a free sexually transmitted diseases (STD) screening program if they self-reported MSM status and had never previously received rectal or oral STD screening. Exclusion criteria included taking antibiotics in the past month. Sociodemographic information, sexual history, and medical history data were collected before taking any samples. Samples were obtained from the rectum, oropharynx, and urethra according to sexual exposure sites. Nucleic acid amplification tests (NAAT) were used to detect CT and NG. Results 380 MSM were enrolled between January 2015 and December 2016. The mean age of participants was 29.79 ±9.10 years, and 18.2% (69/380) were married. Anorectal CT was detected in 18.6% (44/237) of samples and anorectal NG in 10.1% (24/237). Urethral CT was detected in 12.3% (27/ 219) of samples, and urethral NG in 7.8% (17/219) of samples as well. Of 255 oropharyngeal samples, CT was detected in only 2.0% (5/255) and NG in 5.1% (13/255). Two participants (1.5%,2/132) were infected with CT and 1 (0.8%, 1/ 132) with NG at both rectal and urethral sites, three participants (1.4%,3/208) were infected with CT and 8 (3.9%, 8/ 208) with NG at both rectal and oropharyngeal anatomic sites. None participants were infected at three anatomic sites. Conclusion Our findings show that the prevalence of chlamydial and gonococcal infections are high among Chinese MSM, efforts to control CT and NG infection among this key population is of significant public health importance.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.