'WTF is PrEP?': attitudes towards pre-exposure prophylaxis among men who have sex with men and transgender women in New York City (original) (raw)
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International Journal of Environmental Research and Public Health , 2022
We conducted a cross-sectional web-based study to assess attitudes and experiences with HIV pre-exposure prophylaxis (PrEP) amongst a multiracial cohort of gay, bisexual, and other men who have sex with men (MSM) and transgender women in Long Island, New York. Participants were recruited through clinical providers and community-based organizations. The survey assessed knowledge and attitudes toward PrEP and factors that facilitate willingness to take it. Of the 189 respondents, most participants were Latinx/Hispanic (57.1%; n = 105), gay-identifying (81.2%; n = 151), and cisgender men (88.7%; n = 165). One in five participants completed high school or lower (19.4%; n = 36). Among those who had never used PrEP (53.4%; n = 101), nearly all participants were willing to use it if it were free or covered as part of their insurance (89.4%; n = 84). The most common barriers to not using PrEP was not knowing where to obtain it (68.3%; n = 69), concerns about side effects (42.1%; n = 35), and concerns about affordability (38.5%; n = 25). This study discusses specific nuances to the suburbs, including cultural norms and structural barriers that should be incorporated in health promotion initiatives in addressing these factors.
Sexually transmitted infections, 2016
Pre-exposure prophylaxis (PrEP) has gained a central role in prevention of HIV infection among men who have sex with men (MSM), particularly in San Francisco, California, USA. Programmes to enrol men in PrEP are being undertaken by a range of public and private organisations. PrEP will have the largest population impact if it reaches men who are most at risk for HIV infection, and is used in a manner that enables maximal efficacy. Access to PrEP also needs to be equitable. We report on the characteristics of men eligible for and using PrEP. Data were from the 2014 implementation of National HIV Behavioural Surveillance (NHBS) among MSM in San Francisco. NHBS uses venue-based sampling as the national standard for sampling MSM. We compare proportions of demographic characteristics of MSM using versus not using PrEP who are HIV-negative and meet Centers for Disease Control and Prevention guidelines to recommend PrEP. Overall, 64.1% of HIV-negative MSM in San Francisco would meet guidel...
Challenges for HIV Pre-Exposure Prophylaxis among Men Who Have Sex with Men in the United States
Pre-exposure prophylaxis (PrEP) to prevent HIV infection with anti-retroviral (ARV) medications was found to be partially efficacious among men who have sex with men (MSM) [1] and heterosexuals . Other studies have provided information about potential uptake of PrEP among MSM, including factors associated with use and sharing of HIV medications before [4] and after [5] ARV efficacy was known. In a study of high-risk, substance-using MSM in four United States cities conducted prior to the release of efficacy trial results, black and Latino (versus white) MSM were more willing to use a less effective PrEP product in order to avoid condom use [6]; further, high-risk MSM with less education reported more non-prescribed, pre-efficacy ARV use (by HIV-negative men) and sharing of ARVs with sex partners (by HIV-positive men) to prevent HIV infection . In an Internet study of US MSM immediately following release of the efficacy trial results among MSM, black and Latino (versus white) MSM were more willing to use PrEP after efficacy was known .
AIDS Care
Awareness of Pre-exposure prophylaxis (PrEP) was assessed among a cohort of substance-using black men who have sex with men and transgender women (MSM/TGW) participating in the STAR Study, which recruited black MSM/TGW in New York City for HIV testing and linked HIVinfected individuals into care from July 2012 to April 2015. Sociodemographic, psychosocial, known HIV risk factors, and PrEP awareness were assessed among participants. Multivariable logistic regression was conducted to assess factors associated with PrEP awareness. Of 1673 participants, median age was 43 years and 25% were under age 30. Most participants (85.8%) reported having insufficient income for basic necessities at least occasionally, 54.8% were homeless, and 71.3% were unemployed. Awareness of PrEP was reported among 18.2% of participants. PrEP awareness was associated with younger age (adjusted odds ratio [aOR] 0.87, per 5 years), gay identity (aOR 2.46), higher education (aOR 1.70), more frequent past HIV testing (aOR 3.18), less HIV stigma (aOR 0.61), less hazardous/harmful alcohol use (aOR 0.61), and more sexual partners (aOR 1.04, per additional partner in past 30 days). In this substance-using black MSM/TGW cohort with high rates of poverty and homelessness, PrEP awareness was low. This study demonstrates the need for targeted dissemination of PrEP information to key populations to increase awareness and ultimately improve uptake and utilization of PrEP.
AIDS and behavior, 2018
Using cross-sectional data from an ongoing cohort study of young gay, bisexual, and other men who have sex with men (N = 492), we examined the extent to which cognitive factors such as beliefs about the end of AIDS, concerns about the manner in which PrEP works, and perceptions about risk of contracting HIV, are related to PrEP uptake and use. While almost all participants indicted awareness of PrEP, a mere 14% had ever used PrEP. Those with lower concerns about the side effects of PrEP and greater belief that treatment and PrEP would eliminate AIDS were also more likely to have ever used PrEP. Our findings support the ongoing challenges of PrEP uptake as means of curtailing HIV in young sexual minority men, and suggest that beyond the structural factors, consideration must be given to further educating the population as a means of adjusting potentially faulty beliefs, concerns, and perceptions which may influence PrEP utilization.
AIDS and Behavior, 2021
Pre-exposure prophylaxis (PrEP) is an effective form of HIV prevention, but young sexual minority men face myriad barriers to PrEP uptake. Participants (n = 202) completed a survey on healthcare experiences and beliefs about HIV and PrEP. While 98% of the sample knew about PrEP, only 23.2% reported currently taking PrEP. Participants were more likely to be taking PrEP if they received PrEP information from a healthcare provider and endorsed STI-related risk compensation. Conversely, PrEP uptake was less likely among those with concerns about medication use and adherence. While there were no racial/ethnic differences in PrEP uptake, there were differences in correlates of PrEP use for White participants and participants of color. To facilitate PrEP uptake, clinicians should provide PrEP education and screen all patients for PrEP candidacy. Additionally, public health messaging must reframe HIV "risk", highlight benefits of STI testing, and emphasize the importance of preventive healthcare for SMM.
Annals of LGBTQ public and population health, 2020
Despite its proven effectiveness in reducing HIV transmission, pre-exposure prophylaxis (PrEP) use remains low. This study used data from a 2017-2018 U.S. national cohort to investigate social influences on PrEP experience and future PrEP use among cisgender men who have sex with men. We used descriptive statistics and multivariable logistic analyses to examine social influences (e.g., how participants heard about PrEP and number of persons they knew taking PrEP) associated with each previous PrEP use and intentions to use PrEP. Among participants who knew of PrEP, commonly reported ways of first hearing about PrEP were through social media (27.4%) and friends (26.8%). These were also cited top influences on participants' current attitudes toward PrEP (friends 23.5%, social media 22.1%). Multivariable logistic regression analyses found that knowing more people taking PrEP was associated with increased odds of previously using PrEP and intending to use PrEP. Friends and social me...
PloS one, 2018
This study examined HIV testing and use, familiarity, and attitudes toward pre-exposure prophylaxis (PrEP) among HIV-negative gay and bisexual men in the United States. A national probability sample (N = 470) of three age cohorts (18-25, 34-41, and 52-59 years) completed a survey between March, 2016 and March, 2017. Most men did not meet CDC recommendations for HIV testing, and 25.2% of men in the younger cohort had never tested. Only 4.1% used PrEP across cohorts. Visiting an LGBT clinic and searching for LGBT resources online were associated with PrEP use. Men in the middle cohort were more familiar with PrEP (79%) than men in the younger (52%) and older (57%) cohorts. Bisexual and non-urban men were less familiar with PrEP. Attitudes were positive among most men (68.4%) familiar with PrEP. Findings suggest that most men potentially at risk for HIV do not meet CDC guidelines for testing, and PrEP use continues to be minimal. Efforts to educate gay and bisexual men about HIV risk a...