Acceptability of HIV Pre-exposure Prophylaxis (PrEP) Among People Who Inject Drugs (PWID) in a Canadian Setting

Escudero, Daniel J.; Kerr, Thomas; Wood, Evan; Nguyen, Paul; Lurie, Mark N.; Sued, Omar; Marshall, Brandon D.L.

doi:10.1007/s10461-014-0867-z

Cited by 61 publications

(43 citation statements)

References 25 publications

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“…One US study showed 58% of people who inject drugs would use PrEP if it were 90% effective [84]. In Canada, 35% said they would be willing to use PrEP, with higher rates of acceptance among women (42%); younger age, no regular employment, requiring help injecting, engaging in sex work, and reporting multiple recent sexual partners were positively associated with willingness to use PrEP [20]. A small group in a Ukraine study showed higher rates of 86% probable or definite willingness [18].…”

Section: Resultsmentioning

confidence: 99%

Values and Preferences on the Use of Oral Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Multiple Populations: A Systematic Review of the Literature

et al. 2016

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Daily oral pre-exposure prophylaxis (PrEP) is the use of antiretroviral drugs by HIV-negative people to prevent HIV infection. WHO released new guidelines in 2015 recommending PrEP for all populations at substantial risk of HIV infection. To prepare these guidelines, we conducted a systematic review of values and preferences among populations that might benefit from PrEP, women, heterosexual men, young women and adolescent girls, female sex workers, serodiscordant couples, transgender people and people who inject drugs, and among healthcare providers who may prescribe PrEP. A comprehensive search strategy reviewed three electronic databases of articles and HIV-related conference abstracts (January 1990–April 2015). Data abstraction used standardised forms to categorise by population groups and relevant themes. Of 3068 citations screened, 76 peer-reviewed articles and 28 conference abstracts were included. Geographic coverage was global. Most studies (N = 78) evaluated hypothetical use of PrEP, while 26 studies included individuals who actually took PrEP or placebo. Awareness of PrEP was low, but once participants were presented with information about PrEP, the majority said they would consider using it. Concerns about safety, side effects, cost and effectiveness were the most frequently cited barriers to use. There was little indication of risk compensation. Healthcare providers would consider prescribing PrEP, but need more information before doing so. Findings from a rapidly expanding evidence base suggest that the majority of populations most likely to benefit from PrEP feel positively towards it. These same populations would benefit from overcoming current implementation challenges with the shortest possible delay.

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Section: Resultsmentioning

confidence: 99%

Values and Preferences on the Use of Oral Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Multiple Populations: A Systematic Review of the Literature

et al. 2016

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“…One study in the U.S. found that PWID were less likely than other at-risk groups to be aware of PrEP (Walters et al, 2017b). Others found that few PWID in Vancouver were willing to use PrEP, but being at high risk for HIV was associated with increased interest in PrEP (Escudero et al, 2015). Similarly, another study in New York found that sex work and syringe exchange based social networks increased awareness of PrEP among PWID (Walters et al, 2017a).…”

Section: Introductionmentioning

confidence: 99%

PrEP awareness, eligibility, and interest among people who inject drugs in Baltimore, Maryland

Sherman

Schneider

Park

et al. 2019

Drug and Alcohol Dependence

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Background: Limited research has examined pre-exposure prophylaxis (PrEP) interest among people who inject drugs (PWID). To date, few studies have examined the relationship between PrEP eligibility and PrEP interest among PWID. Methods: Data were from an anonymous, cross-sectional survey of Baltimore Syringe Services Program (SSP) clients and non-client peers, restricted to HIV-uninfected participants (N=265). Participants were classified as PrEP eligible/ineligible based on injection related criteria outlined in the CDC’s PrEP guidelines. Participants were asked if they were previously aware of PrEP, would be interested in taking PrEP, and the ease of taking PrEP daily. Participants self-reported their sociodemographic characteristics, health diagnoses, and recent drug use, overdose, and drug treatment history. We estimated bivariate and multivariate logistic regression models to test for significant predictors of interest in PrEP. Results: One-quarter of PWID had previously heard of PrEP and 63% of the sample was interested in taking PrEP. Only two respondents were currently taking PrEP. The majority (89%) thought taking PrEP every day would be easy. In the presence of other variables, PrEP interest was associated with PrEP eligibility (adjusted odds ratio [aOR]=2.46; 95% Confidence Interval [CI]:1.34,4.50) and the number of medical diagnoses (aOR=1.16; 95% CI:1.01,1.33) Conclusions: Most PWID were unaware of PrEP but interested in taking it. PWID who were eligible for PrEP are more likely to be interested in taking it. Having co-morbid conditions was an important correlate of PrEP interest. These results underscore the importance of providers across the healthcare sector engaging PWID in discussions about PrEP.

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“…Prior studies conducted among PWID indicate that 35–47% would be willing to take PrEP(15, 16), yet there are limited studies examining provider perspectives regarding willingness to prescribe PrEP to PWID and, to date, these have focused on individuals who primarily provide HIV treatment(17–19). Understanding the perspectives of primary care physicians (PCPs), however, is highly relevant as they are ideally suited to deliver PrEP given: 1) the large number of primary care providers in practice(20); 2) their central role in disease prevention; 3) their access to populations of potentially PrEP-eligible patients, including PWID(21); and 4) their ability to expand the workforce of PrEP prescribers to increase access to PrEP(22).…”

Section: Introductionmentioning

confidence: 99%

Primary Care Physicians’ Willingness to Prescribe HIV Pre-exposure Prophylaxis for People who Inject Drugs

et al. 2016

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Pre-exposure prophylaxis for HIV (PrEP) is recommended for people who inject drugs (PWID). Despite their central role in disease prevention, willingness to prescribe PrEP to PWID among primary care physicians (PCPs) is largely understudied. We conducted an online survey (April – May 2015) of members of a society for academic general internists regarding PrEP. Among 250 respondents, 74% (n=185) of PCPs reported high willingness to prescribe PrEP to PWID. PCPs were more likely to report high willingness to prescribe PrEP to all other HIV risk groups (p’s<0.03 for all pair comparisons). Compared with PCPs delivering care to more HIV-infected clinic patients, PCPs delivering care to fewer HIV-infected patients were more likely to report low willingness to prescribe PrEP to PWID (Odds Ratio [95% CI]= 6.38 [1.48–27.47]). PCP and practice characteristics were not otherwise associated with low willingness to prescribe PrEP to PWID. Interventions to improve PCPs’ willingness to prescribe PrEP to PWID are needed.

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Acceptability of HIV Pre-exposure Prophylaxis (PrEP) Among People Who Inject Drugs (PWID) in a Canadian Setting

Cited by 61 publications

References 25 publications

Values and Preferences on the Use of Oral Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Multiple Populations: A Systematic Review of the Literature

Values and Preferences on the Use of Oral Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Multiple Populations: A Systematic Review of the Literature

PrEP awareness, eligibility, and interest among people who inject drugs in Baltimore, Maryland

Primary Care Physicians’ Willingness to Prescribe HIV Pre-exposure Prophylaxis for People who Inject Drugs

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