Factors Associated with Being PrEP-Naïve Among a U.S. National Cohort of Former-PrEP and PrEP-Naïve Participants Meeting Objective Criteria for PrEP Care

Carneiro, Pedro B.; Westmoreland, Drew; Patel, Viraj V.; Grov, Christian

doi:10.1007/s10508-020-01791-y

Cited by 7 publications

(7 citation statements)

References 34 publications

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“…Other studies have found similarly low PrEP prescription levels among transgender, PWID, and heterosexual populations. 18,[20][21][22]32 Encouragingly, a large volume of individuals received HIV prevention services through the project, one-third of whom were identified as being at elevated HIV acquisition risk and therefore PrEP-indicated. The large volume of individuals who were PrEP-referred is also encouraging These results suggest that important HIV priority populations can be accessed for HIV prevention and delivered information about PrEP, although much work remains to improve PrEP uptake among these individuals.…”

Section: Discussionmentioning

confidence: 99%

“…However, observed racial/ethnic disparities in PrEP-prescription corroborate previous work. [19][20][21][22] Observed stark differences in the racial/ethnic composition of individuals across the care continuum compared with that of new HIV diagnoses are especially concerning. Other studies have identified complex reasons for these disparities, which include social and structural barriers such as poverty, systemic racism, stigma, and medical mistrust.…”

Section: Discussionmentioning

confidence: 99%

“…[13][14][15][16][17][18] Available data, although limited, report similar racial/ethnic disparities in PrEP use among other priority populations, that is, heterosexual men and women and persons who inject drugs (PWID). [19][20][21][22] Many of these studies were conducted in research settings or among patients receiving care in specific health care settings (eg, sexual health clinics, specialty care clinics). To assess equity in PrEP implementation and delivery, information is needed regarding PrEP care engagement and related racial/ethnic disparities across multiple health care settings, priority populations, and within defined jurisdictions.…”

Section: Introductionmentioning

confidence: 99%

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Reaching Those Most at Risk for HIV Acquisition: Evaluating Racial/Ethnic Disparities in the Preexposure Prophylaxis Care Continuum in Baltimore City, Maryland

Schumacher¹,

Tao²,

Chandran

et al. 2021

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: Reducing HIV incidence requires addressing persistent racial/ethnic disparities in HIV burden. Our goal was to evaluate preexposure prophylaxis (PrEP) delivery, overall and relative to community need, among 7 clinical sites participating in a health department-led demonstration project to increase PrEP in Baltimore city, MD.Methods: PrEP care continuum stages (screened, indicated, referred, linked, evaluated, prescribed) were examined among HIV-negative individuals receiving services at participating sites between September 30, 2015 and September 29, 2019. Community need was defined using information on new HIV diagnoses (2016)(2017)(2018). Differences in care continuum progression by demographics/priority population and comparison of demographic compositions between care continuum stages and new HIV diagnoses were examined using modified Poisson regression and x 2 tests, respectively.Results: Among 25,886 PrEP-screened individuals, the majority were non-Hispanic (NH) black (81.1%, n = 20,998), cisgender male (61.1%, n = 15,825), and heterosexual (86.7%, n = 22,452). Overall, 31.1% (n = 8063) were PrEP-indicated; among whom, 56.8% (n = 4578), 15.6% (n = 1250), 10.8% (n = 868), and 9.0% (n = 722) were PrEP-referred, linked, evaluated, and prescribed, respectively. Among 2870 men who have sex with men (MSM), 18.7% (n = 538) were PrEP-prescribed. Across all groups, the highest attrition was between PrEP-referred and PrEP-linked. NHblack race (vs. NH-white) was independently associated with lower likelihood of PrEP prescription (aPR, 0.89; 95% confidence interval, 0.81 to 0.98 controlling for age/gender). Relative to the demographic composition of new HIV diagnoses, fewer NH-blacks (80.2% vs. 54.3%) and more NH-whites (10.7% vs. 30.3%) and MSM were PrEP prescribed (55.2% vs. 74.5%).Conclusions: This project showed promise delivering PrEP referrals and prescriptions overall and to MSM. Substantial improvement is needed to improve linkage overall and to decrease disparities in PrEP prescriptions among NH-blacks. Future work should focus on addressing service gaps that hinder PrEP utilization.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Reaching Those Most at Risk for HIV Acquisition: Evaluating Racial/Ethnic Disparities in the Preexposure Prophylaxis Care Continuum in Baltimore City, Maryland

Schumacher¹,

Tao²,

Chandran

et al. 2021

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

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“…This was shown in a serial cross-sectional survey design with 2398 Black MSM [ 34 ], a repeated cross-sectional survey design with 398 MSM at time 1 and 558 MSM at time 2 [ 35 ], and a cross-sectional design with 374 MSM [ 36 ]. Similarly, in a cross-sectional study of 6283 predominantly cisgender men that did not report sexual identity or behaviors, depressive symptoms were not correlated with PrEP use [ 59 ]. In a cross-sectional study of 247 predominantly cisgender males from Philadelphia, Pennsylvania (PA), there was no relationship between depressive symptoms and self-reported PrEP use [ 58 ].…”

Section: Depressionmentioning

confidence: 99%

“…PrEP Initiation. One large national US cohort study, enrolling 6283 cisgender men and transgender individuals who have sex with men demonstrated that anxiety symptoms were not associated with self-reported individual prior or current use of PrEP [ 59 ].…”

Section: Anxietymentioning

confidence: 99%

A Scoping Review Investigating Relationships between Depression, Anxiety, and the PrEP Care Continuum in the United States

Miller

Harrison

Sanasi-Bhola

2021

IJERPH

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Men who have sex with men and transgender women in the United States are at increased risk for HIV and may benefit from pre-exposure prophylaxis (PrEP), a once-a-day pill to prevent HIV. Due to stigma and discrimination, sexual and gender minority (SGM) populations are also at risk for depression and anxiety. This scoping review sought to identify literature addressing relationships between the PrEP care continuum, depression, and anxiety among SGM individuals and others at high risk for HIV. We conducted a systematic review of four databases (i.e., PubMed, PsycInfo, Web of Science, Google Scholar) and identified 692 unique articles that were screened for inclusion criteria, with 51 articles meeting the final inclusion criteria. Data were extracted for key study criteria (e.g., geographic location, participant demographics, study design, main findings). Results suggest that while depression and anxiety are not associated with PrEP awareness or willingness to use, they can be barriers to seeking care and to PrEP adherence. However, empirical studies show that taking PrEP is associated with reductions in anxiety. Findings suggest the need to implement mental health screenings in PrEP clinical care. In addition, addressing systemic and structural issues that contribute to mental health disorders, as well as PrEP-related barriers, is critical.

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Infrequent STI Testing in New York City Among High Risk Sexual and Gender Minority Individuals Interested In Self- and Partner-Testing

et al. 2021

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Factors Associated with Being PrEP-Naïve Among a U.S. National Cohort of Former-PrEP and PrEP-Naïve Participants Meeting Objective Criteria for PrEP Care

Cited by 7 publications

References 34 publications

Reaching Those Most at Risk for HIV Acquisition: Evaluating Racial/Ethnic Disparities in the Preexposure Prophylaxis Care Continuum in Baltimore City, Maryland

Reaching Those Most at Risk for HIV Acquisition: Evaluating Racial/Ethnic Disparities in the Preexposure Prophylaxis Care Continuum in Baltimore City, Maryland

A Scoping Review Investigating Relationships between Depression, Anxiety, and the PrEP Care Continuum in the United States

Infrequent STI Testing in New York City Among High Risk Sexual and Gender Minority Individuals Interested In Self- and Partner-Testing

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