Awareness of post-exposure HIV prophylaxis in high-risk men who have sex with men in New York City.
ABSTRACT To understand the factors associated with knowledge of non-occupational post-exposure prophylaxis (nPEP) and pre-exposure prophylaxis (PrEP), bathhouse patrons in New York City (NYC) were surveyed.
554 men who have sex with men (MSM) at two NYC bathhouses were given a standardised survey focused on nPEP and PrEP at the time of HIV testing.
In the previous 90 days, 63% of respondents reported unprotected sex with a male partner and 7% reported any sex with a known HIV-positive male partner. Less than half reported having a primary provider (primary care practitioner) who was aware of their MSM behaviour. 201 men (36%) were aware of nPEP or PrEP. In univariate analyses, race/ethnicity, previous HIV testing, gay self-identification, higher education level, having a primary provider aware of MSM behaviour, reported interaction with the healthcare system, use of the internet for meeting sex partners, reporting unprotected sex in the previous 90 days, reporting any sex with an HIV-positive male partner in the previous 90 days and having a higher number of sex partners were each significantly associated with being aware of nPEP or PrEP. In multivariate analysis, having a higher number of sex partners was significantly associated (OR 5.10, p=0.02) with post-exposure prophylaxis (PEP)/PrEP knowledge and disclosure to a primary care provider was also associated, although less robustly (OR 2.10, p=0.06).
Knowledge of nPEP or PrEP among sexually active MSM in NYC is low and is associated with having a primary provider aware of their patient's same-sex behaviours. These findings show the need for improving education about nPEP among high-risk MSM in NYC and the role of providers in these efforts.
- SourceAvailable from: Jose Arturo Bauermeister[Show abstract] [Hide abstract]
ABSTRACT: Pre-exposure prophylaxis (PrEP) has the potential to help reduce new HIV/AIDS infections among young men who have sex with men (YMSM); however, PrEP's accessibility and affordability remains questionable. Using a cross-sectional survey of YMSM (N=1,507; ages 18-24; 65% White, 9% Black, 17% Latino, 9% Other race/ethnicity), we gauged YMSM's PrEP awareness and PrEP-related beliefs regarding accessibility and affordability. Overall, 27% of the sample had heard about PrEP; 1% reported ever using PrEP prior to sex. In a multivariate logistic regression, we found that YMSM were more likely to have heard about PrEP if they were older (OR=1.12), more educated (OR=1.20), had insurance (OR=1.47), and reported at least one sexually-acquired infection (STI) in their lifetime (OR=1.81). We noted no differences by sexual risk behavior or race/ethnicity. Once a description of PrEP was offered to survey participants, two thirds of the sample (64.4%) noted that they would not know where to acquire PrEP, nor believed that they would able to afford it (62.4%). In multivariate linear regression models, YMSM's belief of PrEP accessibility was associated with insurance (b=.24), identifying as Latino (b=.23) or Asian (b=.42), and having heard about PrEP in the past (b=.40). PrEP affordability belief was associated with insurance (b=-.44) and a prior STI (b=.21). Black (b=-.28), Asian (b=-.07), or Other Race/Ethnicity (b=-.52) YMSM were less likely than Whites to report PrEP affordability belief. PrEP rollout may be hindered due to awareness, accessibility and affordability barriers. We propose strategies to maximize equity in PrEP awareness, access and use among YMSM.141st APHA Annual Meeting and Exposition 2013; 11/2013
- [Show abstract] [Hide abstract]
ABSTRACT: Despite treatment guidelines in place since 2005, non-occupational post-exposure HIV prophylaxis (nPEP) remains an underutilized prevention strategy. We conducted a retrospective chart review of patients presenting to a publicly-funded HIV clinic in Seattle, Washington for nPEP between 2000 and 2010 (N = 360). nPEP prescriptions were provided for 324 (90%) patients; 83% of prescription decisions were appropriate according to Centers for Disease Control and Prevention guidelines, but only 31% (N = 111/360) of patients were considered "high risk." In order to use limited resources most efficiently, public health agencies should target messaging for this high-cost intervention to individuals with high-risk HIV exposures.PLoS ONE 01/2014; 9(8):e105030. · 3.53 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: We aimed to determine the trends in numbers and percentages of sexually exposed persons to HIV (SE) consulting an ED for post-exposure prophylaxis (PEP), as well as predictors of condom use.PLoS ONE 01/2014; 9(8):e104350. · 3.53 Impact Factor