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. 2016 Sep 1;63(5):672-7.
doi: 10.1093/cid/ciw367. Epub 2016 Jun 9.

Willingness to Take, Use of, and Indications for Pre-exposure Prophylaxis Among Men Who Have Sex With Men-20 US Cities, 2014

Brooke E Hoots  1 , Teresa Finlayson  1 , Lina Nerlander  2 , Gabriela Paz-Bailey  1 ; National HIV Behavioral Surveillance Study Group
Collaborators, Affiliations

Willingness to Take, Use of, and Indications for Pre-exposure Prophylaxis Among Men Who Have Sex With Men-20 US Cities, 2014

Brooke E Hoots et al. Clin Infect Dis. .

Abstract

Background: Pre-exposure prophylaxis (PrEP) is an effective prevention tool for people at substantial risk of acquiring human immunodeficiency virus (HIV). To monitor the current state of PrEP use among men who have sex with men (MSM), we report on willingness to use PrEP and PrEP utilization. To assess whether the MSM subpopulations at highest risk for infection have indications for PrEP according to the 2014 clinical guidelines, we estimated indications for PrEP for MSM by demographics.

Methods: We analyzed data from the 2014 cycle of the National HIV Behavioral Surveillance (NHBS) system among MSM who tested HIV negative in NHBS and were currently sexually active. Adjusted prevalence ratios and 95% confidence intervals were estimated from log-linked Poisson regression with generalized estimating equations to explore differences in willingness to take PrEP, PrEP use, and indications for PrEP.

Results: Whereas over half of MSM said they were willing to take PrEP, only about 4% reported using PrEP. There was no difference in willingness to take PrEP between black and white MSM. PrEP use was higher among white compared with black MSM and among those with greater education and income levels. Young, black MSM were less likely to have indications for PrEP compared with young MSM of other races/ethnicities.

Conclusions: Young, black MSM, despite being at high risk of HIV acquisition, may not have indications for PrEP under the current guidelines. Clinicians may need to consider other factors besides risk behaviors such as HIV incidence and prevalence in subgroups of their communities when considering prescribing PrEP.

Keywords: HIV; MSM; PrEP; United States; pre-exposure prophylaxis.

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Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1
Figure 1
Prevalence of pre-exposure prophylaxis (PrEP) use in the past 12 months by city among human immunodeficiency virus (HIV)-uninfected, sexually active men who have sex with men in the National HIV Behavioral Surveillance system, 2014. Abbreviations: CA, California; CO, Colorado; DC, District of Columbia; FL, Florida; GA, Georgia; IL, Illinois; LA, Louisiana; MA, Massachusetts; MD, Maryland; MI, Michigan; NJ, New Jersey; NY, New York; PA, Pennsylvania; PR, Puerto Rico; TX, Texas; WA, Washington.
See this image and copyright information in PMC

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