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

National HIV Behavioral Surveillance Study Group

Research output: Contribution to journalArticle

89 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)672-677
Number of pages6
JournalClinical Infectious Diseases
Volume63
Issue number5
DOIs
StatePublished - Sep 1 2016

Fingerprint

HIV
Pre-Exposure Prophylaxis
Guidelines
Risk-Taking
Demography
Confidence Intervals
Education
Incidence
Infection

Keywords

  • HIV
  • MSM
  • pre-exposure prophylaxis
  • PrEP
  • United States

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Willingness to Take, Use of, and Indications for Pre-exposure Prophylaxis Among Men Who Have Sex With Men - 20 US Cities, 2014. / National HIV Behavioral Surveillance Study Group.

In: Clinical Infectious Diseases, Vol. 63, No. 5, 01.09.2016, p. 672-677.

Research output: Contribution to journalArticle

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title = "Willingness to Take, Use of, and Indications for Pre-exposure Prophylaxis Among Men Who Have Sex With Men - 20 US Cities, 2014",
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, pre-exposure prophylaxis, PrEP, United States",
author = "{National HIV Behavioral Surveillance Study Group} and Hoots, {Brooke E.} and Teresa Finlayson and Lina Nerlander and Gabriela Paz-Bailey and Pascale Wortley and Jeff Todd and Kimi Sato and Colin Flynn and Danielle German and Dawn Fukuda and Rose Doherty and Chris Wittke and Nikhil Prachand and Nanette Benbow and Jimenez, {Antonio D.} and Jonathon Poe and Shane Sheu and Alicia Novoa and Alia Al-Tayyib and Melanie Mattson and Vivian Griffin and Emily Higgins and Kathryn Macomber and Salma Khuwaja and Hafeez Rehman and Paige Padgett and Sey, {Ekow Kwa} and Yingbo Ma and Marlene LaLota and Schacht, {John Mark} and Forrest, {David W} and Bridget Anderson and Amber Sinclair and Lou Smith and Robinson, {William T.} and Narquis Barak and Zarwell, {Meagan C.} and Alan Neaigus and Reilly, {Kathleen H.} and Barbara Bolden and Afework Wogayehu and Henry Godette and Brady, {Kathleen A.} and Mark Shpaner and Jennifer Shinefeld and Lissa Bayang and Veronica Tovar-Moore and Raymond, {H. Fisher} and Theresa Ick and {De Le{\'o}n}, {Sandra Miranda}",
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T1 - Willingness to Take, Use of, and Indications for Pre-exposure Prophylaxis Among Men Who Have Sex With Men - 20 US Cities, 2014

AU - National HIV Behavioral Surveillance Study Group

AU - Hoots, Brooke E.

AU - Finlayson, Teresa

AU - Nerlander, Lina

AU - Paz-Bailey, Gabriela

AU - Wortley, Pascale

AU - Todd, Jeff

AU - Sato, Kimi

AU - Flynn, Colin

AU - German, Danielle

AU - Fukuda, Dawn

AU - Doherty, Rose

AU - Wittke, Chris

AU - Prachand, Nikhil

AU - Benbow, Nanette

AU - Jimenez, Antonio D.

AU - Poe, Jonathon

AU - Sheu, Shane

AU - Novoa, Alicia

AU - Al-Tayyib, Alia

AU - Mattson, Melanie

AU - Griffin, Vivian

AU - Higgins, Emily

AU - Macomber, Kathryn

AU - Khuwaja, Salma

AU - Rehman, Hafeez

AU - Padgett, Paige

AU - Sey, Ekow Kwa

AU - Ma, Yingbo

AU - LaLota, Marlene

AU - Schacht, John Mark

AU - Forrest, David W

AU - Anderson, Bridget

AU - Sinclair, Amber

AU - Smith, Lou

AU - Robinson, William T.

AU - Barak, Narquis

AU - Zarwell, Meagan C.

AU - Neaigus, Alan

AU - Reilly, Kathleen H.

AU - Bolden, Barbara

AU - Wogayehu, Afework

AU - Godette, Henry

AU - Brady, Kathleen A.

AU - Shpaner, Mark

AU - Shinefeld, Jennifer

AU - Bayang, Lissa

AU - Tovar-Moore, Veronica

AU - Raymond, H. Fisher

AU - Ick, Theresa

AU - De León, Sandra Miranda

PY - 2016/9/1

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N2 - 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.

AB - 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.

KW - HIV

KW - MSM

KW - pre-exposure prophylaxis

KW - PrEP

KW - United States

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DO - 10.1093/cid/ciw367

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JO - Clinical Infectious Diseases

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