PrEP Usage Varies By Place

In 2012, the US Food and Drug Administration approved the use of a pill called Truvada for HIV prevention (known as Pre-Exposure Prophylaxis, or PrEP). Taken once a day, PrEP greatly reduces the likelihood of HIV infection in the event of an exposure to near zero. “It’s the most promising biomedical prevention strategy we have seen since the advent of medication to treat HIV-positive individuals more than two decades ago,” said Dr. Grov. Health providers have been aggressively trying to spread the word about PrEP, particularly for populations that have been disproportionally impacted by the HIV epidemic. In the U.S., that includes gay and bisexual men. In fact, the World Health Organization has recommended that all HIV-negative gay and bisexual men consider adopting PrEP as among the strategies they use to prevent contracting HIV.

Yet, the uptake of PrEP among key population has been slower than expected. Thus Dr. Grov and his colleagues sought to investigate willingness to use PrEP as well as experience taking PrEP in a large sample of gay and bisexual men. Grov and his colleagues examined the data they had amassed from nearly 3,000 men over a 17-month period between 2014 and 2015. Participant’s willingness to start PrEP has not changed over time and was overall high (even at its lowest, more than half of the men surveyed via NYC gay nightlife list-servs said they would be willing to start PrEP. Meanwhile more than 2/3rds of men surveyed via NYC sex party list-servs, geo-social networking apps, and Facebook expressed willingness to use PrEP). In addition, the number of men who had experience taking PrEP had increased over this 17-month time period. “This suggests that the roll out of PrEP has had some success, but there is more work to do,” said Grov.

Their survey also found that willingness to take PrEP was associated with being younger, single, a person of color, and having been tested for HIV in the last 12 months. “This tells us that very populations that could benefit most from PrEP are actually interested in taking it.” In the U.S., men of color, particularly younger men of color are experiencing exceptionally high HIV infections in recent years. In addition, men who are single (and sexually active) would certainly benefit from PrEP.

Finally, the survey also found where men were surveyed was associated with whether they had prior experience taking PrEP, or not. “In some places, like via NYC sex party list-servs as well as one of the apps we surveyed men, more than a quarter of men reported having taken PrEP in the past. But only 2% of the men we surveyed via one of the hook up websites we advertised on had experience taking PrEP,” said Grov. “This tells us that we can use digital medium to engage both men who have experience taking PrEP as well as identify men who would benefit from PrEP, but might yet have done so. It informs both researchers and providers how best to channel their resources depending on who they want to reach.”

The full results from the study will be published this fall in AIDS Education and Prevention.

Grov, C., Rendina, H. J., Jimenez, R., and Parsons, J. T. (2016). Using online settings to identify gay and bisexual men willing to take or with experience taking PrEP: Implications for researchers and providers. AIDS Education and Prevention, 28, page TBA

Hunter College Center for HIV/AIDS Educational Studies and Training (CHEST)