Dataset Information

HIV Preexposure Prophylaxis Initiation at a Large Community Clinic: Differences Between Eligibility, Awareness, and Uptake.

ABSTRACT: OBJECTIVES:To characterize uptake of HIV preexposure prophylaxis (PrEP) in a community setting and to identify disparities in PrEP use by demographic and behavioral factors associated with increased HIV risk. METHODS:We conducted a cross-sectional study of 19?587 men who have sex with men and transgender people visiting a Los Angeles, California, clinic specializing in lesbian, gay, bisexual, and transgender care between August 2015 and February 2018 by using clinical care data. RESULTS:Seventy percent of patients met PrEP eligibility criteria, while 10% reported PrEP use. Using sex drugs, reporting both condomless anal intercourse and recent sexually transmitted infection, older age, and higher education level were associated with higher odds of PrEP use given eligibility. Latino or Asian race/ethnicity and bisexual orientation were associated with lower odds of PrEP use given eligibility. Higher odds of perceived need were associated with demographic risk factors but PrEP use was not similarly elevated. CONCLUSIONS:Discrepancies between PrEP eligibility, perceived need, and use reveal opportunities to improve PrEP delivery in community settings. Public Health Implications. Efforts are needed to facilitate PrEP uptake in populations with highest HIV incidence.

SUBMITTER: Shover CL

PROVIDER: S-EPMC6137770 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

HIV Preexposure Prophylaxis Initiation at a Large Community Clinic: Differences Between Eligibility, Awareness, and Uptake.

Shover Chelsea L CL Javanbakht Marjan M Shoptaw Steven S Bolan Robert K RK Lee Sung-Jae SJ Parsons Jeffrey T JT Rendina Jonathon J Gorbach Pamina M PM

American journal of public health 20180823 10

<h4>Objectives</h4>To characterize uptake of HIV preexposure prophylaxis (PrEP) in a community setting and to identify disparities in PrEP use by demographic and behavioral factors associated with increased HIV risk.<h4>Methods</h4>We conducted a cross-sectional study of 19 587 men who have sex with men and transgender people visiting a Los Angeles, California, clinic specializing in lesbian, gay, bisexual, and transgender care between August 2015 and February 2018 by using clinical care data.<h ...[more]

PMID: 30138062

Similar Datasets

Project description:Several randomized clinical trials have demonstrated the efficacy of preexposure prophylaxis (PrEP) in preventing human immunodeficiency virus (HIV) acquisition. Little is known about adherence to the regimen, sexual practices, and overall effectiveness when PrEP is implemented in clinics that treat sexually transmitted infections (STIs) and community-based clinics serving men who have sex with men (MSM).To assess PrEP adherence, sexual behaviors, and the incidence of STIs and HIV infection in a cohort of MSM and transgender women initiating PrEP in the United States.Demonstration project conducted from October 1, 2012, through February 10, 2015 (last date of follow-up), among 557 MSM and transgender women in 2 STI clinics in San Francisco, California, and Miami, Florida, and a community health center in Washington, DC. Data were analyzed from December 18, 2014, through August 8, 2015.A combination of daily, oral tenofovir disoproxil fumarate and emtricitabine was provided free of charge for 48 weeks. All participants received HIV testing, brief client-centered counseling, and clinical monitoring.Concentrations of tenofovir diphosphate in dried blood spot samples, self-reported numbers of anal sex partners and episodes of condomless receptive anal sex, and incidence of STI and HIV acquisition.Overall, 557 participants initiated PrEP, and 437 of these (78.5%) were retained through 48 weeks. Based on the findings from the 294 participants who underwent measurement of tenofovir diphosphate levels, 80.0% to 85.6% had protective levels (consistent with ?4 doses/wk) at follow-up visits. African American participants (56.8% of visits; P?=?.003) and those from the Miami site (65.1% of visits; P?<?.001) were less likely to have protective levels, whereas those with stable housing (86.8%; P?=?.02) and those reporting at least 2 condomless anal sex partners in the past 3 months (88.6%; P?=?.01) were more likely to have protective levels. The mean number of anal sex partners declined during follow-up from 10.9 to 9.3, whereas the proportion engaging in condomless receptive anal sex remained stable at 65.5% to 65.6%. Overall STI incidence was high (90 per 100 person-years) but did not increase over time. Two individuals became HIV infected during follow-up (HIV incidence, 0.43 [95% CI, 0.05-1.54] infections per 100 person-years); both had tenofovir diphosphate levels consistent with fewer than 2 doses/wk at seroconversion.The incidence of HIV acquisition was extremely low despite a high incidence of STIs in a large US PrEP demonstration project. Adherence was higher among those participants who reported more risk behaviors. Interventions that address racial and geographic disparities and housing instability may increase the impact of PrEP.

Dataset Information

HIV Preexposure Prophylaxis Initiation at a Large Community Clinic: Differences Between Eligibility, Awareness, and Uptake.

Publications

HIV Preexposure Prophylaxis Initiation at a Large Community Clinic: Differences Between Eligibility, Awareness, and Uptake.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets