Socioeconomic disparities associated with awareness, access, and usage of Pre-Exposure Prophylaxis among Latino MSM ages 21–30 in San Antonio, TX

Abstract

HIV continues to disproportionately affect Latino men who have sex with men (MSM) and disparities are even greater in the South. This study examines the implications of socioeconomic status (SES) associated with awareness, access, and usage of PrEP. Latino MSM (N=154) from San Antonio, TX completed a self-administered survey. Results revealed that PrEP uptake was significantly lower for low SES Latino MSM. PrEP related barriers included lack of awareness, stigmas, and side effects. Findings underscore the importance for a multi-systemic approach to enhance awareness and access of PrEP for Latino MSM with varying levels of SES in the South. HIV incidence rates have decreased for White men who have sex with men (MSM) and stabilized for Black MSM, but have increased by 30% for Latino MSM and more than doubled for ages 25-34 (CDC, 2019). Texas (TX) has one of the highest HIV prevalence rates for Latinos (CDC, 2018a). HIV incidence rates for San Antonio-New Braunfels, TX is 15.2 per 100,000 compared to 11.8 for the nation (CDC, 2018a; Levison, Levinson, & Alegría, 2018; Pérez, Santamaria, & Operario, 2017). Recently, a highly HIV infectious cluster was identified among Latino MSM ages 20-29 in San Antonio, Texas (CDC, 2018a). The San Antonio cluster raised the concern of a missed opportunity for Latino MSM that received treatment for a sexually transmitted infection, but were not tested for HIV, despite having signs of acute infection (CDC, 2018a). The HIV epidemic in the US currently indicates that HIV prevention has been stagnant and not effectively addressing the needs of

Using a structural-ecological model to facilitate adoption of preexposure prophylaxis among Latinx sexual minority men: A systematic literature review.

“…As previously noted, one major barrier to PrEP implementation among Latinx SMM, is the lack of culturally adapted information and awareness surrounding this biomedical prevention (Barreras et al, 2019; Garcia & Saw, 2019). This is particularly relevant for Latinx SMM who face additional barriers associated with lower socioeconomic status (SES; Garcia & Saw, 2019). Garcia and Saw (2019) document that overall, Latinx SMM with lower SES were more likely to be severely underserved and uninformed on PrEP.…”

“…This is particularly relevant for Latinx SMM who face additional barriers associated with lower socioeconomic status (SES; Garcia & Saw, 2019). Garcia and Saw (2019) document that overall, Latinx SMM with lower SES were more likely to be severely underserved and uninformed on PrEP. At the individual level, Latinx SMM who were primarily Spanish-speaking were also significantly less likely to be aware of PrEP (Brooks, Nieto, et al, 2019; Mansergh et al, 2019).…”

“…Eleven studies described specific barriers to accessing PrEP at the structural level for Latinx SMM. Variables included data on health insurance, social institutions, cultural, and political structures (Barreras et al, 2019; Brooks, Landrian, et al, 2019; García & Harris, 2017; Garcia & Saw, 2019; Marks et al, 2017; Page et al, 2017; Mustanski et al, 2018). As previously noted in this review, there are unique individual-level cognitive barriers, including beliefs about PrEP, concerns about taking PrEP and its side effects that impact the implementation of PrEP among Latinx SMM (Barreras et al, 2019; Bauermeister et al, 2013; Brooks, Landrian, et al, 2019).…”

A State of the Science on HIV Prevention Over 40 Years Among Black and Hispanic/Latinx Communities

“…Socioeconomic challenges, poor health care access, and stigma are direct barriers to HIV prevention efforts in Black and Hispanic/Latinx populations. Socioeconomic difficulties may include inability to afford health insurance or co-pays, a lack of transportation access to health care providers, and a relative absence of health care serving organizations in socioeconomically deprived areas ( Garcia & Saw, 2019 ; Ransome et al, 2016 ; Turner et al, 2019 ). These difficulties, driven in part by discrimination in employment, education, income, and housing, create challenges in accessing and using health care ( Logie et al, 2018 ).…”

“Family before Anyone Else”: A Qualitative Study on Family, Marginalization, and HIV among Hispanic or Latino/a/x Mexican Sexual Minority Males

“…Hispanics or Latino/a/x are less likely to be knowledgeable of their HIV status, achieve HIV viral suppression, and engage in pre-exposure prophylaxis (PrEP) [ 1 , 5 ]. A study conducted in San Antonio, TX, US indicated that Hispanic or Latino/a/x sexual minority males with a higher socioeconomic status (SES) were more likely to be aware of PrEP, but fears of being stigmatized as promiscuous discouraged them from enrolling in PrEP [ 6 ]. The same study found that Hispanic or Latino/a/x sexual minority males with a lower SES were less aware of PrEP and less likely to consider PrEP due to it being considered an experimental drug, medical side effects, and government mistrust [ 6 ].…”