Knowledge and Use of Pre-Exposure Prophylaxis Among an Online Sample of Young Men Who Have Sex with Men in New York City

Abstract

Understanding prior knowledge and experience with pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) is critical to its implementation. In fall 2011, NYC MSM were recruited via banner advertisements on six popular dating websites and asked questions about their knowledge and use of PrEP (n = 329). Overall, 123 (38%) respondents reported knowledge of PrEP, of whom two (1.5%) reported PrEP use in the past 6 months. Knowledge of PrEP was associated with high educational attainment, gay identity and recent HIV testing, suggesting an uneven dissemination of information about PrEP and missed opportunities for education. To avoid disparities in use during scale-up, MSM should be provided with additional information about PrEP.

Minimal Awareness and Stalled Uptake of Pre-Exposure Prophylaxis (PrEP) Among at Risk, HIV-Negative, Black Men Who Have Sex with Men

“…18,19 In order to increase uptake of PrEP, it is critical that we focus attention on how PrEP is being embraced by populations at-risk for HIV. Our understanding of community perspectives of PrEP suggests that there are multiple limitations to accessing it, 10,11,[20][21][22][23][24] and that populations in need might not be receiving information about PrEP. 25 We must also acknowledge that those who are at greatest risk for HIV may be least likely to be aware of its availability or have the means to access it.…”

Estimating HIV Protective Effects of Method Adherence With Combinations of Preexposure Prophylaxis and Condom Use Among African American Men Who Have Sex With Men

“…20,21 As indicated in this analysis, for MSM never using PrEP, the only change in HIV prevention method use that is likely to result in an increased number of HIV infections is movement from not using PrEP while always using condoms (323 infections; 95% CI, 167-625) to using PrEP inconsistently in combination with inconsistent (684 infections; 95% CI, 260-1801)-a 112% increase-or never (744 infections; 95% CI, 297-1863) condom use-a 130 % increase.…”

“…Risk compensation resulting from condom promotion has been demonstrated in a single randomized trial where persons in communities randomized to condom promotion increased both condom use and the number of sexual partners compared with those in control communities. 21 Some studies suggest that condom risk compensation is resulting from a belief in the effectiveness of highly active antiretroviral therapy (HAART) in reducing risk of transmission from a virally suppressed HIVinfected sex partner. [26][27][28] Currently, there are 2 antiretroviral-based HIV prevention methods proven highly effective in randomized controlled trials: consistent use of daily oral PrEP medication and consistent HAART use by persons diagnosed as having HIV infection to lower the risk of transmitting to uninfected partners.…”

Pre-exposure prophylaxis for South African adolescents: What evidence?

“…[22,23] Knowledge was found to be associated with higher education, recent HIV testing and gay identity, [21] as well as increased age, having had a sexually transmitted infection and having health insurance. [20] In all studies, there was generally a positive attitude towards PrEP and a willingness to use it.…”

“…Generally, knowledge of PrEP was limited, 27 -38% of study participants having heard of PrEP and 1 -1.5% having used it, [20,21] with many expressing a desire for more information. [22,23] Knowledge was found to be associated with higher education, recent HIV testing and gay identity, [21] as well as increased age, having had a sexually transmitted infection and having health insurance.…”