High Interest in Preexposure Prophylaxis Among Men Who Have Sex With Men at Risk for HIV Infection

Abstract

Background Pre-exposure prophylaxis (PrEP) is the first biomedical intervention with proven efficacy to reduce human immunodeficiency virus (HIV) acquisition in men who have sex with men (MSM) and transgender women (TGW). Little is known about levels of interest and characteristics of individuals who elect to take PrEP in real-world clinical settings. Methods The US PrEP Demonstration Project is a prospective, open-label cohort study assessing PrEP delivery in municipal STD clinics in San Francisco and Miami and a community health center in Washington, DC. HIV-uninfected MSM and TGW seeking sexual health services at participating clinics were assessed for eligibility and offered up to 48 weeks of emtricitabine/tenofovir for PrEP. Predictors of enrollment were assessed using a multivariable Poisson regression model, and characteristics of enrolled participants are described. Results Of 1069 clients assessed for participation, 921 were potentially eligible and 557 (60.5%) enrolled. In multivariable analysis, participants from Miami (aRR 1.53; 95% CI 1.33-1.75) or DC (aRR 1.33; 95% CI 1.2-1.47), those who were self-referred (aRR 1.48; 95% CI 1.32-1.66), with prior PrEP awareness (aRR 1.56; 95% CI 1.05-2.33) and those reporting >1 episode of anal sex with an HIV-infected partner in the last 12 months (aRR 1.20; 95% CI 1.09-1.33) were more likely to enroll. Almost all (98%) of enrolled participants were MSM, and at baseline, 63.5% reported condomless receptive anal sex in the prior three months. Conclusions Interest in PrEP is high among a diverse population of MSM at risk for HIV infection when offered in STD and community health clinics.

Stigma and Conspiracy Beliefs Related to Pre-exposure Prophylaxis (PrEP) and Interest in Using PrEP Among Black and White Men and Transgender Women Who Have Sex with Men

“…Further delays in these areas, put simply, costs lives -there is urgent need to bolster efforts to improve awareness and accessibility. Importantly, however, and similar to prior research, it appears that interest in PrEP is at least moderate [26]. We also note that PrEP interest was greater among BMTW than WMTW.…”

Promoting Pre-exposure Prophylaxis to Prevent HIV Infections Among Sexual and Gender Minority Hispanics/Latinxs

“…In a qualitative study of Spanish-speaking MSM living in New York City, the vast majority had not heard about PrEP, but interest was high once they learned about it (Martinez, Wu et al, 2016). This is consistent with other studies in diverse settings where Latino MSM report high willingness to take PrEP, once they are aware of its benefits (Cohen et al, 2015; Lelutiu-Weinberger & Golub, 2016; Snowden, Chen, McFarland, & Raymond, 2017). …”

Willingness to use pre-exposure prophylaxis among Black and White men who have sex with men in Atlanta, Georgia

“…However, 56% of those with low risk behavior reported UAI in the previous 12 months, and 28.5% were diagnosed with HIV or an STI during study follow-up demonstrating some degree of discordance between perceived and actual risk. Findings from the US PrEP Demonstration Project also noted a similar discrepancy between perceived and actual HIV risk 15 . Formal population-specific risk assessment tools which combine risk-behavior assessment with local epidemiologic risk are urgently needed to identify and maximize PrEP uptake in high-risk MSM who would most benefit from PrEP.…”