Pre-Exposure Prophylaxis (PrEP) Awareness Is Low Among Heterosexual People of Color Who Might Benefit From PrEP in Philadelphia

Abstract

Introduction: We assessed awareness of pre-exposure prophylaxis (PrEP) among HIV-negative Black and Latinx persons living in the Philadelphia Metropolitan Statistical Area. Methods: Using chi-square and Wilcoxon rank-sum tests, we analyzed data from the 2016 heterosexual cycle of the National HIV Behavioral Surveillance system to assess how sociodemographic factors, health care utilization, and risk behaviors affected PrEP awareness. Results: Participants (n = 472) were predominately Black, non-Hispanic (88.1%) with a median age of 41.5 years. Most participants reported having a usual source of medical care (92.1%) and seeing a medical provider within 12 months (87.0%). However, PrEP awareness was low in this sample (4.9%) and was lower among those who had a medical visit compared with those who had not ( P < .01). Conclusion: Current Centers for Disease Control and Prevention clinical guidelines suggest that providers counsel high-risk patients about PrEP. Our data suggest that this is not happening with people of color in Philadelphia. Interventions targeting medical providers working with HIV-risk people of color may be appropriate.

Sociocultural and structural influences on HIV Pre-Exposure Prophylaxis (PrEP) Engagement and Uptake among African American Young adults

“…This finding has implications for PrEP engagement and access among African American men, especially MSM. Public health messages that destigmatize and normalize the potential benefits of PrEP for all individuals, irrespective of sexual and gender identity, who use condoms inconsistently and have concurrent sexual partners and/or those with unknown HIV status [ 53 ] may help improve attitudes toward PrEP among cisgender heterosexual and LGBTQ + African American young men engaging in high-risk behaviors. Other studies have documented that African American men are uncomfortable discussing or disclosing their sexual behaviors with their providers [ 9 , 54 ], stemming from medical mistrust and perceived risk of discrimination [ 54 ].…”

Urban Sexual Health Clinic Patients With “Undetermined Risk” for HIV Are Less Likely to Receive Preexposure Prophylaxis

“…From the patient perspective, a survey conducted among heterosexual adults in Philadelphia found that PrEP awareness was low (4.9%), and high-risk behavior was not associated with higher PrEP awareness. 20 From the provider perspective, a survey of 363 HIV providers assessing attitudes about PrEP found that providers were least likely to consider prescribing PrEP to heterosexuals. 21 A major challenge in identifying patients at the highest risk for HIV transmission is reliance on knowing the risk status of one's partners.…”

“…Lower fractions of PrEP prescriptions among those with undetermined risk are likely multifactorial including decreased awareness and other patient-level and provider-level factors. From the patient perspective, a survey conducted among heterosexual adults in Philadelphia found that PrEP awareness was low (4.9%), and high-risk behavior was not associated with higher PrEP awareness 20 . From the provider perspective, a survey of 363 HIV providers assessing attitudes about PrEP found that providers were least likely to consider prescribing PrEP to heterosexuals 21 …”