Correlates of Preexposure Prophylaxis (PrEP) Use among Men Who Have Sex with Men (MSM) in Los Angeles, California

Okafor, Chukwuemeka N.; Gorbach, Pamina M.; Ragsdale, Amy; Quinn, Brendan; Shoptaw, Steven

doi:10.1007/s11524-017-0172-z

Cited by 60 publications

(37 citation statements)

References 17 publications

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“…However, PrEP awareness and knowledge is a single factor in a host of indicators for PrEP use, and increasing functional knowledge about PrEP is not a sufficient strategy for increasing PrEP uptake among MSM [ 54 ]. Unwillingness to use PrEP has been found to be associated with concerns about side effects, access to health care, and HIV-related stigma across multiple populations of MSM [ 19 , 20 , 55 - 57 ]. Addressing concerns about PrEP and reducing barriers to PrEP access may be more critical to motivating PrEP, particularly in populations where general PrEP awareness is already high.…”

Section: Discussionmentioning

confidence: 99%

Functional Knowledge of Pre-Exposure Prophylaxis for HIV Prevention Among Participants in a Web-Based Survey of Sexually Active Gay, Bisexual, and Other Men Who Have Sex With Men: Cross-Sectional Study

Kahle¹,

Sullivan²,

Stephenson³

2018

JMIR Public Health Surveill

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BackgroundAwareness of pre-exposure prophylaxis (PrEP) for HIV prevention is increasing, but little is known about the functional knowledge of PrEP and its impact on willingness to use PrEP.ObjectiveThe objective of this study was to assess the functional knowledge of PrEP among a sample of gay, bisexual, and other men who have sex with men (MSM) participating in a Web-based survey of sexually active MSM.MethodsMen at least 18 years old, residing in the United States, and reporting sex with a man in the previous 6 months were recruited through social networking websites. PrEP functional knowledge included the following 4 questions (1) efficacy of consistent PrEP use, (2) inconsistent PrEP use and effectiveness, (3) PrEP and condom use, and (4) effectiveness at reducing sexually transmitted infections (STIs). Ordinal logistic regression was used to identify respondent characteristics associated with PrEP functional knowledge. In a subsample of participants responding to HIV prevention questions, we compared willingness to use PrEP by response to PrEP functional knowledge using logistic regression analysis adjusted for age, race and ethnicity, and education level.ResultsAmong 573 respondents, PrEP knowledge was high regarding adherence (488/573, 85.2%), condom use (532/573, 92.8%), and STIs (480/573, 83.8%), but only 252/573 (44.0%) identified the correct efficacy. Lower functional PrEP knowledge was associated with minority race/ethnicity (P=.005), lower education (P=.01), and not having an HIV test in the past year (P=.02). Higher PrEP knowledge was associated with willingness to use PrEP (P=.009). Younger age was not associated with higher PrEP functional knowledge or willingness to use PrEP.ConclusionsPrEP knowledge was generally high in our study, including condom use and consistent use but may be lacking in higher risk MSM. The majority of respondents did not correctly identify PrEP efficacy with consistent use, which could impact motivation to seek out PrEP for HIV prevention. Targeted messaging to increase PrEP knowledge may increase PrEP use.

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Section: Discussionmentioning

confidence: 99%

Functional Knowledge of Pre-Exposure Prophylaxis for HIV Prevention Among Participants in a Web-Based Survey of Sexually Active Gay, Bisexual, and Other Men Who Have Sex With Men: Cross-Sectional Study

Kahle¹,

Sullivan²,

Stephenson³

2018

JMIR Public Health Surveill

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“…The methodology of our ongoing prospective cohort study (‘mSTUDY’) has been described in detail elsewhere . Briefly, it is a National Institute of Drug Abuse‐funded program with the overall objective of measuring factors linking substance use with dynamics of HIV transmission and progression (e.g.…”

Section: Methodsmentioning

confidence: 99%

Investigating possible syndemic relationships between structural and drug use factors, sexual HIV transmission and viral load among men of colour who have sex with men in Los Angeles County

Quinn

Gorbach

Okafor

et al. 2020

Drug and Alcohol Review

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Introduction and Aims. Past research investigating syndemic factors and HIV-related outcomes has overlooked the impact of structural conditions on behaviours linked with HIV transmission and disease progression. Given prevalent substance use among our sample, we explored whether four structural conditions indicative of social marginalisation and previously correlated with increased risk for HIV infection demonstrated syndemic (additive/synergistic) effects on: (i) HIV viral suppression; and (ii) self-reported involvement in sexual HIV transmission behaviours among a prospective cohort mostly comprising men of colour who have sex with men (MCSM; i.e. Latino/Hispanic and African American/black men) in Los Angeles County. Design and Methods. Data were collected between August 2014 and March 2017. The structural conditions of interest were: current unemployment, recent (≤6 months) incarceration history, 'unstable' accommodation (past month) and remote (>6 months) contact with health-care providers. Generalised estimating equations assessed possible additive effects of experiencing multiple structural conditions, and possible synergistic effects on the HIVrelated outcomes. Results. Of 428 participants, nearly half (49%) were HIV-positive at baseline. Involvement in sexual HIV transmission risk behaviours varied over follow-up (22-30%). Reporting ≥2 structural syndemic conditions was significantly associated with reporting sexual HIV transmission risk behaviours among HIV-negative participants, and detectable viral load among HIV-positive participants. Frequent methamphetamine use was consistently associated with the HIV-related outcomes across the final multivariate models. Discussion and Conclusions. When developing initiatives to address HIV transmission among marginalised sub-populations including MCSM, we must holistically consider systemic and structural issues (e.g. unemployment and homelessness), especially in the context of prevalent substance use. [Quinn B, Gorbach PM, Okafor CN, Heinzerling KG, Shoptaw S. Investigating possible syndemic relationships between structural and drug use factors, sexual HIV transmission and viral load among men of colour who have sex with men in Los Angeles County. Drug Alcohol Rev 2020;39:116-127]

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“…Limited research is available on the initiation of and adherence to PrEP among Black MSM in the US . The importance of developing effective interventions and methods for delivering these interventions is essential to reducing the disproportionate HIV burden among BMSM in the United States inclusive of health provider biases .…”

Section: Introductionmentioning

confidence: 99%

“…Evidence‐based research is needed to address this vital public health priority, including culturally sensitive care and support services that address the structural barriers . We report results from an open‐label antiretroviral PrEP demonstration project, HIV Prevention Trials Network 073 (HPTN 073) that examined the uptake/initiation and adherence with daily oral co‐formulated emtricitabine and tenofovir disoproxil fumarate (FTC/TDF) among Black MSM in three US cities.…”

Section: Introductionmentioning

confidence: 99%

Pre‐exposure prophylaxis initiation and adherence among Black men who have sex with men (MSM) in three US cities: results from the HPTN 073 study

et al. 2019

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Introduction Randomized clinical trials have demonstrated the efficacy of antiretroviral pre‐exposure prophylaxis (Pr EP ) in preventing HIV acquisition among men who have sex with men ( MSM ). However, limited research has examined initiation and adherence to Pr EP among Black MSM ( BMSM ) in the United States ( US ) who are disproportionately represented among newly HIV infected and late to care individuals. This research reports on the HIV Prevention Trials Network 073 ( HPTN 073) study aimed to examine Pr EP initiation, utilization and adherence among Black MSM utilizing the theoretically principled, culturally informed and client‐centered care coordination (C4) model. Methods The HPTN 073 study enrolled and followed 226 HIV ‐uninfected Black MSM in three US cities (Los Angeles, CA ; Washington DC ; and Chapel Hill, NC ) from February 2013 through September 2015. Study participants were offered once daily oral emtricitabine/tenofovir ( FTC / TDF ) Pr EP combined with C4 and followed up for 52 weeks. Participants received HIV testing, risk reduction education and clinical monitoring. Results Of the 226 men enrolled, 178 participants initiated Pr EP (79%), and of these 64% demonstrated Pr EP utilization at week 26 (mid‐point of the study) based on pharmacokinetic testing. Condomless anal sex with an HIV ‐infected or unknown status casual male partner was statistically significantly associated with a greater likelihood of Pr EP initiation (adjusted odds ratio ( OR ) 4.4, 95% confidence interval ( CI ) 1.7, 11.7). Greater age (≥25 vs. <25, OR 2.95, 95% CI 1.37 –6.37), perception of having enough money ( OR 3.6, 95% CI 1.7 to 7.7) and knowledge of male partner taking Pr EP before sex ( OR 2.22, 95% CI 1.03 to 4.79) were statistically significantly associated with increased likelihood of Pr EP adherence at week 26. Annualized HIV incidence was 2.9 (95% CI 1.2 to 7.9) among those who init...

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Correlates of Preexposure Prophylaxis (PrEP) Use among Men Who Have Sex with Men (MSM) in Los Angeles, California

Cited by 60 publications

References 17 publications

Functional Knowledge of Pre-Exposure Prophylaxis for HIV Prevention Among Participants in a Web-Based Survey of Sexually Active Gay, Bisexual, and Other Men Who Have Sex With Men: Cross-Sectional Study

Functional Knowledge of Pre-Exposure Prophylaxis for HIV Prevention Among Participants in a Web-Based Survey of Sexually Active Gay, Bisexual, and Other Men Who Have Sex With Men: Cross-Sectional Study

Investigating possible syndemic relationships between structural and drug use factors, sexual HIV transmission and viral load among men of colour who have sex with men in Los Angeles County

Pre‐exposure prophylaxis initiation and adherence among Black men who have sex with men (MSM) in three US cities: results from the HPTN 073 study

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