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. 2021 Feb 1:219:108477.
doi: 10.1016/j.drugalcdep.2020.108477. Epub 2021 Jan 7.

Willingness to initiate pre-exposure prophylaxis (PrEP) and its use among opioid-dependent individuals in drug treatment

Zhao Ni  1 , Frederick L Altice  2 , Jeffrey A Wickersham  3 , Michael M Copenhaver  4 , Elizabeth E DiDomizio  5 , LaRon E Nelson  6 , Roman Shrestha  3
Affiliations

Willingness to initiate pre-exposure prophylaxis (PrEP) and its use among opioid-dependent individuals in drug treatment

Zhao Ni et al. Drug Alcohol Depend. .

Abstract

Background: People who use drugs (PWUD) continue to experience a disproportionate HIV burden due to drug- and sex-related risk behaviors. Pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV infection, but very little is known about PrEP use among PWUD and their willingness to initiate PrEP.

Methods: We conducted a cross-sectional survey among 234 HIV-negative, opioid-dependent individuals recruited from an urban methadone clinic. Participants were assessed using an audio-computer assisted self-interview technique. Bivariate and multiple logistic regressions were used to explore independent correlates of actual PrEP use and willingness to initiate PrEP.

Results: One-fourth (25.6 %) of participants had previously used PrEP. Over two-thirds (67.1 %) of participants had previously heard of PrEP, and 65.0 % were willing to take it. In multivariable logistic regression analyses, the number of times participants engaged in HIV testing (aOR = 1.66, p < 0.01) and whether they visited a healthcare provider (aOR=20.81, p = 0.02) were associated with a higher likelihood of PrEP use, while perceived HIV risk (aOR=2.71, p < 0.01) and previous use of PrEP (aOR=3.57, p < 0.01) were significantly associated with willingness to initiate PrEP.

Conclusion: PrEP use was low among PWUD, but their willingness to initiate PrEP was moderate, which indicated a significant discrepancy between actual PrEP use and willingness to use it. Our findings highlight the importance of healthcare providers engaging opioid-dependent individuals in discussions about PrEP and the need for innovative strategies to increase their awareness of PrEP and modify their perceptions of HIV risk.

Keywords: HIV prevention; Opioid use disorder; Opioid-dependent; People who use drugs (PWUD); Pre-exposure prophylaxis (PrEP); Sexual risk behavior; Substance use.

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Conflict of interest statement

Conflict of Interest: The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Where participants heard about PrEP (n=157)
See this image and copyright information in PMC

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