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Correlates of Preexposure Prophylaxis (PrEP) Use among Men Who Have Sex with Men (MSM) in Los Angeles, California

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Abstract

We assessed socio-structural and behavioral correlates of preexposure prophylaxis (PrEP) for HIV infection among a sample of high-risk HIV-negative men who have sex with men (MSM) in Los Angeles, California. Participants from an ongoing 5-year prospective cohort study investigating the direct impacts of substance use on HIV transmission dynamics were enrolled between February 2015 and January 2017. All men completed a computer-assisted self-interview every 6 months that assessed recent (past 6 months) PrEP use and socio-structural and behavioral factors. Of the total 185 MSM (mean age = 29 years) included in the study, majority were African American (40%) or Hispanic (41%) and reported current health insurance coverage (80%). In multivariable analysis using log-binomial regression, having health insurance coverage [adjusted prevalence ratio (aPR) 2.02; 95% confidence interval (CI) 1.01 to 4.01, p = 0.04] was associated with recent PrEP use. Unstable housing (aPR = 0.44, 95% CI 0.22 to 0.90, p = 0.02) was associated with lower PrEP use. Behavioral factors associated with recent PrEP use include sex with a HIV-positive partner (aPR = 3.63, 95% CI 1.45 to 9.10, p = 0.01), having six or more sex partners (aPR = 2.20, 95% CI 1.26 to 3.82, p = <0.01), and popper use (aPR = 2.76, 95% CI 1.58 to 4.84, p = <0.01). In this sample of predominantly racial/ethnic minority MSM, socio-structural and behavioral factors were important factors associated with recent PrEP use. These findings provide considerations for intervention development to promote PrEP use among key groups of MSM.

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Acknowledgements

We are grateful to the participants for contributing their time in this study.

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Authors and Affiliations

  1. Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Ave (Room 37-121CHS), Los Angeles, CA, 90095-1688, USA

    Chukwuemeka N Okafor & Amy Ragsdale

  2. Department of Epidemiology, Fielding School of Public Health, Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA

    Pamina M. Gorbach

  3. Behaviours & Health Risks Program, Burnet Institute, Melbourne, Australia

    Brendan Quinn

  4. Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, USA

    Steve Shoptaw

Authors
  1. Chukwuemeka N Okafor
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  2. Pamina M. Gorbach
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  3. Amy Ragsdale
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  4. Brendan Quinn
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  5. Steve Shoptaw
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Corresponding author

Correspondence to Chukwuemeka N Okafor.

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The Institutional Review Boards at the University of California, Los Angeles, approved the study.

Funding

This work was supported by the National Institute on Drug Abuse grant U01DA036267, the MStudy (PI: Gorbach, Shoptaw); the UCLA Postdoctoral Fellowship Training Program in Global HIV Prevention Research grant T32MH080634 (PI: Currier, Gorbach); and the Center for HIV Identification, Prevention, and Treatment Services NIMH grant PS30 MH58107. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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Okafor, C.N., Gorbach, P.M., Ragsdale, A. et al. Correlates of Preexposure Prophylaxis (PrEP) Use among Men Who Have Sex with Men (MSM) in Los Angeles, California. J Urban Health 94, 710–715 (2017). https://doi.org/10.1007/s11524-017-0172-z

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