Dataset Information

Racial and Ethnic Disparities in HIV Pre-exposure Prophylaxis Awareness Among Men Who have Sex with Men.

ABSTRACT: Racial and ethnic disparities exist in HIV pre-exposure prophylaxis (PrEP) awareness and care. We evaluated how racial and ethnic disparities in PrEP awareness among MSM presenting to a sexually transmitted disease clinic changed from 2013 to 2016. Among 1243 MSM (68% non-Hispanic White, 22% Hispanic, and 10% non-Hispanic Black), PrEP awareness increased overall, but awareness was lower among Hispanic and non-Hispanic Black MSM relative to non-Hispanic White MSM. Awareness converged among non-Hispanic Black and White MSM by 2016, but remained consistently lower among Hispanic MSM. Improved efforts are needed to address disparities in PrEP awareness.

SUBMITTER: Raifman J

PROVIDER: S-EPMC6744997 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Racial and Ethnic Disparities in HIV Pre-exposure Prophylaxis Awareness Among Men Who have Sex with Men.

Raifman Julia J Dean Lorraine T LT Montgomery Madeline C MC Almonte Alexi A Arrington-Sanders Renata R Stein Michael D MD Nunn Amy S AS Sosnowy Collette D CD Chan Philip A PA

AIDS and behavior 20191001 10

Racial and ethnic disparities exist in HIV pre-exposure prophylaxis (PrEP) awareness and care. We evaluated how racial and ethnic disparities in PrEP awareness among MSM presenting to a sexually transmitted disease clinic changed from 2013 to 2016. Among 1243 MSM (68% non-Hispanic White, 22% Hispanic, and 10% non-Hispanic Black), PrEP awareness increased overall, but awareness was lower among Hispanic and non-Hispanic Black MSM relative to non-Hispanic White MSM. Awareness converged among non-Hi ...[more]

PMID: 30874995

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Project description:IntroductionPre-exposure prophylaxis (PrEP) is a key HIV prevention technology, and is a pillar of a comprehensive HIV prevention approach for men who have sex with men (MSM). Because there have been no national data to characterize trends in the PrEP continuum in the United States, overall and for key demographic groups of MSM, we aimed to describe the extent to which PrEP awareness, willingness and use changed over time, overall and for specific groups of MSM critical for HIV prevention (e.g. Black and Hispanic MSM, younger MSM, MSM in rural areas and MSM without health coverage).MethodsThe American Men's Internet Survey (AMIS) is an annual survey of US MSM conducted in the United States among MSM aged ?15 years since 2013. We analysed data on trends in elements of the PrEP continuum (awareness, willingness and use of PrEP) in a sample of 37,476 HIV-negative/unknown status MSM from December 2013 through November 2017. We evaluated trends in continuum steps overall and among demographic subgroups using Poisson models with Generalized Estimating Equations. For 2017 data, we used logistic regression to compare the prevalence of PrEP use among demographic groups.ResultsOverall, 51.4% (n = 19,244) of AMIS respondents were PrEP-eligible across study years. Between 2013 and 2017, PrEP awareness increased from 47.4% to 80.6% willingness to use PrEP increased from 43.9% to 59.5% and PrEP use in the past 12 months increased from 1.7% to 19.9%. In 2017, use of PrEP was lower for men who were younger, lived outside of urban areas, and lacked health insurance; PrEP use was not different among Black, Hispanic and white MSM.ConclusionsOur data show progress in use of PrEP among US MSM, but also reveal mismatches between PrEP use and epidemic need. We call for additional support of PrEP initiation, especially among young, non-urban and uninsured MSM. Black and Hispanic MSM report levels of PrEP use no different from white MSM, but given higher HIV incidence for Black and Hispanic MSM, parity in use is not sufficient for epidemic control or health equity.

Project description:BACKGROUND:Pre-exposure prophylaxis (PrEP) is currently an important tool for HIV prevention, especially in communities with higher risk of infection, notably men who have sex with men (MSM). To date, PrEP has remained generally unavailable in many cities around the world. In the planning of strategies for PrEP targeting MSM, community assessment is crucial to understand members' responses to the new intervention. OBJECTIVE:Awareness and acceptance are 2 different but intricately linked contexts of PrEP. The aim of this study was to identify the determinants of awareness and acceptance of PrEP among MSM and to delineate their interrelationships in Hong Kong where PrEP services have not been developed. METHODS:A Web-based questionnaire survey was administered in light of the popularity of the internet as a platform for information and networking in the MSM community. Factors associated with PrEP acceptance and awareness were separately analyzed, and their predictors were subsequently tested by multivariate logistic regression. Associations between acceptance and awareness of PrEP were examined by factor network analysis. RESULTS:Between August and September 2016, results from a total of 453 HIV-negative MSM were analyzed. Half (49.7%, 225/453) of the respondents were aware of PrEP, and 78.3% (355/453) would consider using PrEP when it becomes available. Awareness of PrEP was associated with recent (P=.01) and ongoing (P=.04) use of psychotropic drugs for sex (chemsex). MSM who used online forums to seek sex partners had lower awareness (P=.04) than those visiting physical venues for sex networking. MSM who accepted PrEP were more likely users of internet channels for sex networking (P=.049), especially location-based social network apps (P=.04). MSM accepting PrEP were more concerned about their partners' HIV status (P=.002), history of sexually transmitted infections (P=.01), condom use (P=.02), and HIV testing behavior (P=.02). Multivariate logistic regressions revealed that PrEP awareness was related to one's networking pattern, whereas its acceptance was associated with inclination to self-protect from HIV. Factor network analysis highlighted the importance of chemsex, which was linked by over half of the edges, whereas the rest were contributed by HIV testing behaviors. CONCLUSIONS:In Hong Kong, the overall awareness among MSM toward PrEP was only moderate but their acceptance was higher. Targeting MSM with chemsex behaviors through Web-based platforms and parallel development of tailored HIV testing services are important when introducing PrEP in the community.

Dataset Information

Racial and Ethnic Disparities in HIV Pre-exposure Prophylaxis Awareness Among Men Who have Sex with Men.

Publications

Racial and Ethnic Disparities in HIV Pre-exposure Prophylaxis Awareness Among Men Who have Sex with Men.

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