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. 2024 Oct 8:13:100288.
doi: 10.1016/j.dadr.2024.100288. eCollection 2024 Dec.

Associations of HIV pre-exposure prophylaxis (PrEP) indication, HIV risk perception and unwillingness to use PrEP among people who inject drugs in Baltimore, MD

Tarfa Verinumbe  1 , Gregory M Lucas  1 , Katie Zook  1 , Brian Weir  2 , Miles Landry  1 , Kathleen R Page  1 , Susan G Sherman  2 , Oluwaseun Falade-Nwulia  1
Affiliations

Associations of HIV pre-exposure prophylaxis (PrEP) indication, HIV risk perception and unwillingness to use PrEP among people who inject drugs in Baltimore, MD

Tarfa Verinumbe et al. Drug Alcohol Depend Rep. .

Abstract

Background: Perceived HIV risk may impact willingness to initiate PrEP among people who inject drugs (PWID).

Methods: We analyzed baseline data from PrEP eligible PWID in Baltimore, MD. Risk perception was assessed by PWID relative to the average risk of their age group categorized as: higher-than, lower-than, or about average. Participants were informed of PrEP for HIV prevention and asked about their willingness to use daily PrEP. Associations of PrEP indication (categorized as injection risk only vs any sexual risk), perceived HIV risk and non-willingness to use PrEP was assessed using generalized linear models.

Results: Among 489 participants, 61 % were male, 66 % were Black and mean age was 46 years. One-third (35 %) of the participants were aware of PrEP and <1 % had used PrEP in the prior 30 days. Overall, 30 % of PWID reported lower-than-average perceived HIV risk and 18 % reported non-willingness to use PrEP. Participants with injection risk only were more likely (aOR: 2.75; 95 %CI: 1.60 - 4.73) to report having lower-than-average perceived HIV risk compared to those with any sexual risk. Participants with lower-than-average perceived risk were more likely to report non-willingness to use PrEP compared to those with higher perceived risk (adjusted PR: 1.91; 95 %CI: 1.18 - 3.10).

Conclusion: A considerable proportion of PWID eligible for PrEP reported having low risk of HIV acquisition despite being eligible for PrEP. Consistent and tailored PrEP messaging that addresses drug use HIV risk perception may be critical to increasing PrEP uptake among PWID.

Keywords: HIV; People who inject drugs; Pre-exposure prophylaxis; Risk perception; United States.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
PrEP eligibility and PrEP cascade among people who inject drugs in Baltimore, MD (2018).
See this image and copyright information in PMC

References

    1. Atkins A., McClung R.P., Kilkenny M., Bernstein K., Willenburg K., Edwards A., Lyss S., Thomasson E., Panneer N., Kirk N., Watson M., Adkins E., DiNenno E., Hogan V., Neblett Fanfair R., Napier K., Ridpath A.D., Perdue M., Chen M., Oster A.M. Notes from the field: outbreak of human immunodeficiency virus infection among persons who inject drugs - cabell county, West Virginia, 2018-2019. MMWR Morb. Mortal Wkly Rep. 2020;69(16):499–500. doi: 10.15585/mmwr.mm6916a2. - DOI - PMC - PubMed
    1. Bazzi A.R., Biancarelli D.L., Childs E., Drainoni M.L., Edeza A., Salhaney P., Mimiaga M.J., Biello K.B. Limited knowledge and mixed interest in pre-exposure prophylaxis for HIV prevention among people who inject drugs. AIDS Patient Care STDS. 2018;32(12):529–537. doi: 10.1089/apc.2018.0126. - DOI - PMC - PubMed
    1. Biello K.B., Bazzi A.R., Mimiaga M.J., Biancarelli D.L., Edeza A., Salhaney P., Childs E., Drainoni M.L. Perspectives on HIV pre-exposure prophylaxis (PrEP) utilization and related intervention needs among people who inject drugs. Harm. Reduct. J. 2018;15(1):55. doi: 10.1186/s12954-018-0263-5. - DOI - PMC - PubMed
    1. Broz D., Wejnert C., Pham H.T., DiNenno E., Heffelfinger J.D., Cribbin M., Krishna N., Teshale E.H., Paz-Bailey G. HIV infection and risk, prevention, and testing behaviors among injecting drug users - National HIV Behavioral Surveillance System, 20 U.S. cities, 2009. MMWR Surveill Summ. 2014;63(6):1–51. - PubMed
    1. Bush K., Kivlahan D.R., McDonell M.B., Fihn S.D., Bradley K.A. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol use disorders identification test. Arch. Intern. Med. 1998;158(16):1789–1795. doi: 10.1001/archinte.158.16.1789. - DOI - PubMed

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