Willingness to Use HIV Pre-Exposure Prophylaxis Among Opiate Users

Abstract

Few studies of pre-exposure prophylaxis (PrEP) to prevent HIV infection have focused on drug users. Between February to September 2013, we asked 351 opiate injectors entering detoxification treatment about HIV risk, knowledge about PrEP, and willingness to use a once daily PrEP pill under one of two randomly assigned effectiveness scenarios −40% (low) or 90% (high) effective in reducing HIV risk. Participants were 70% male and 87% non-Hispanic White. Only 7% had heard of a drug to reduce HIV risk, yet once informed, 47% would be willing to take such a pill [35% of those in the low effectiveness scenario and 58% in the high group (p < .001)]. Higher perceived HIV risk was associated with greater willingness to take medication. Increasing knowledge of PrEP and the rate of HIV reduction-effectiveness promised will influence its use among targeted high-risk drug users.

Acceptability of HIV Pre-exposure Prophylaxis (PrEP) Among People Who Inject Drugs (PWID) in a Canadian Setting

“…The results presented in this study differ from those published by Eisingerich, et al, [11], and Stein, et al, [12], in which overall acceptability were higher, particularly in Ukraine. These differences are likely due to a host of social and contextual factors, including: the stage of the HIV epidemic in the respective settings, the relative availability of other HIV prevention services (including NSPs, HIV treatment access, and the availability of OST), and perhaps other cultural differences.…”

“…However, this does not necessarily mean that those without recent injection behavior would not be eligible for PrEP, given the sexual risk behaviors observed, and also the strong likelihood for injection drug relapse observed in other PWID populations [28]. In fact, the risk profile in our sample may actually be closer to those participating in the Bangkok Tenofovir Study (where 55% of participants did not report any injection drug use during study follow-up [4]) than the opiate users seeking detoxification surveyed by Stein, et al (where only recent injectors were eligible to participate [12]).…”

“…In fact, only two studies to date have published data demonstrating willingness to use PrEP among a samples of PWID, one among PWID in Ukraine [11], and more recently in Massachusetts, United States (U.S.) [12]. In the study examining Ukrainian PWID, data were collected from a sample of 128 active injectors, 86% of whom were “definitely” or “probably” willing to take PrEP [11].…”

Primary Care Physicians’ Willingness to Prescribe HIV Pre-exposure Prophylaxis for People who Inject Drugs

“…Prior studies conducted among PWID indicate that 35–47% would be willing to take PrEP(15, 16), yet there are limited studies examining provider perspectives regarding willingness to prescribe PrEP to PWID and, to date, these have focused on individuals who primarily provide HIV treatment(17–19). Understanding the perspectives of primary care physicians (PCPs), however, is highly relevant as they are ideally suited to deliver PrEP given: 1) the large number of primary care providers in practice(20); 2) their central role in disease prevention; 3) their access to populations of potentially PrEP-eligible patients, including PWID(21); and 4) their ability to expand the workforce of PrEP prescribers to increase access to PrEP(22).…”

HIV-Negative Partnered Men's Willingness to Use Pre-Exposure Prophylaxis and Associated Factors Among an Internet Sample of U.S. HIV-Negative and HIV-Discordant Male Couples

“…Recent studies have examined attitudes, awareness and willingness to use PrEP among MSM primarily in the U.S., [21][22][23][24][25][26][27][28][29][30][31] with more limited research in Australia, China, France, Thailand, UK, and Canada [32][33][34][35][36][37][38][39] through an individual lens, focusing on the individual characteristics of men that shape their desire and ability to use and adhere to PrEP. In general, this body of research has illustrated that MSM, and in particular high-risk MSM (those with multiple sex partners), have positive attitudes towards the adoption of PrEP as a HIV prevention strategy.…”