AIDS and Behavior

, Volume 20, Issue 7, pp 1435–1442 | Cite as

Correlates of Awareness of and Willingness to Use Pre-exposure Prophylaxis (PrEP) in Gay, Bisexual, and Other Men Who Have Sex with Men Who Use Geosocial-Networking Smartphone Applications in New York City

  • William C. Goedel
  • Perry N. Halkitis
  • Richard E. Greene
  • Dustin T. Duncan
Original Paper

Abstract

Geosocial-networking smartphone applications are commonly used by gay, bisexual, and other men who have sex with men (MSM) to meet sexual partners. The purpose of the current study was to evaluate awareness of and willingness to use pre-exposure prophylaxis (PrEP) among MSM who use geosocial-networking smartphone applications residing in New York City. Recruitment utilizing broadcast advertisements on a popular smartphone application for MSM yielded a sample of 152 HIV-uninfected MSM. Multivariable models were used to assess demographic and behavioral correlates of awareness of and willingness to use PrEP. Most participants (85.5 %) had heard about PrEP but few (9.2 %) reported current use. Unwillingness to use PrEP was associated with concerns about side effects (PR = 0.303; 95 % CI 0.130, 0.708; p = 0.006). Given that more than half (57.6 %) of participants were willing to use PrEP, future research is needed to elucidate both individual and structural barriers to PrEP use among MSM.

Keywords

Gay men’s health Men who have sex with men (MSM) Pre-exposure prophylaxis (PrEP) Geosocial-networking smartphone applications 

Résumén

El uso de los aplicaciones de teléfonos inteligentes es común entre los homosexuales, bisexuales, y otros hombres que tienen sexo con hombres (HSH) para cumplir con las parejas sexuales. El objetivo del estudio fue evaluar la conciencia y la voluntad de utilizar la profilaxis pre-exposición (PrEP) entre los HSH que usan aplicaciones para teléfonos inteligentes que residen en la ciudad de Nueva York. El reclutamiento se utilizan anuncios de difusión en una aplicación para teléfonos inteligentes popular para los HSH dio una muestra de 152 HSH sin VIH. Modelos multivariables se utilizaron para evaluar los correlatos demográficos y conductuales de la conciencia y la voluntad de utilizar PrEP. La mayoría de los participantes (85.5 %) eran conscientes de PrEP, pero u poco (9.2 %) reportado el uso actual. Renuencia a usar PrEP se asocio con preocupaciones sobre los efectos secundarios (PR = 0.303; 95 CI 0.130, 0.708; p = 0.006). Dado que más de la mitad (57.6 %) de los participantes estaban dispuesto a utilizar PrEP, se necesitan investigaciones futuras para dilucidar las barreras individuales y estructurales del uso de PrEP entre los HSH.

References

  1. 1.
    Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, Vargas L, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–99.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Smith D, Grant R, Weidle P, Lansky A, Mermin J, Fenton K. Interim guidance: preexposure prophylaxis for the prevention of HIV infection in men who have sex with men. MMWR Morb Mortal Wkly Rep. 2011;60(3):65–8.Google Scholar
  3. 3.
    Volk JE, Marcus JL, Phengrasamy T, Blechinger D, Nguyen DP, Follansbee S, et al. No new HIV infections with increasing use of HIV preexposure prophylaxis in a clinical practice setting. Clin Infect Dis. 2015;61(10):1601–3.CrossRefPubMedGoogle Scholar
  4. 4.
    Chen A, Dowdy DW. Clinical effectiveness and cost-effectiveness of HIV pre-exposure prophylaxis in men who have sex with men: risk calculators for real-world decision-making. PLoS ONE. 2014;9(1):e108742.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Desai K, Sansom SL, Ackers ML, Stewart SR, Hall HI, Hu DJ, et al. Modeling the impact of HIV chemoprophylaxis strategies among men who have sex with men in the United States: HIV infections prevented and cost-effectiveness. AIDS. 2008;22(14):1829–39.CrossRefPubMedGoogle Scholar
  6. 6.
    Paltiel AD, Freedberg KA, Scott CA, Schackman BR, Losina E, Wang B, et al. HIV preexposure prophylaxis in the United States: impact on lifetime infection risk, clinical outcomes, and cost-effectiveness. Clin Infect Dis. 2009;48(6):806–15.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Karris MY, Beekmann SE, Mehta SR, Anderson CM, Polgreen PM. Are we prepped for preexposure prophylaxis (PrEP)? Provider opinions on the real-world use of PrEP in the United States and Canada. Clin Infect Dis. 2013;58(5):704–12.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
  9. 9.
    Tuller D. A resisted pill to prevent H.I.V.: The New York TImes. 2013. http://www.nytimes.com/2013/12/31/health/a-resisted-pill-to-prevent-hiv.html.
  10. 10.
  11. 11.
    Brown E, Flores A. Truvada, a pill to fight HIV, stires controversy among gays. 2013.http://www.latimes.com/local/countygovernment/la-me-truvada-20141203-story.html.
  12. 12.
    Golub SA, Kowalczyk W, Weinberger CL, Parsons JT. Preexposure prophylaxis and predicted condom use among high-risk men who have sex with men. J Acquir Immune Defic Syndr. 2010;54(5):548–55.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Crary DT. HIV prevention drug, divides gay community. Huffington Post. 2014. http://www.huffingtonpost.com/2014/04/07/truvada-gay-men-hiv_n_5102515.html.
  14. 14.
    Grov C, Whitfield TH, Rendina HJ, Ventuneac A, Parsons JT. Willingness to take PrEP and potential for risk compensation among highly sexually active gay and bisexual men. AIDS Behav. 2015;19(12):2234–44.CrossRefPubMedGoogle Scholar
  15. 15.
    Marcus JL, Glidden DV, Mayer KH, Liu AY, Buchbinder SP, Amico KR, et al. No evidence of sexual risk compensation in the iPrEx trial of daily oral HIV preexposure prophylaxis. PLoS ONE. 2013;8(12):e81997.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Pérez-Figueroa RE, Kapadia F, Barton SC, Eddy JA, Halkitis PN. Acceptability of PrEP uptake among racially/ethnically diverse young men who have sex with men: the P18 Study. AIDS Educ Prev. 2015;27(2):112–25.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Mehta SA, Silvera R, Bernstein K, Holzman RS, Aberg JA, Daskalakis DC. Awareness of post-exposure HIV prophylaxis in high-risk men who have sex with men in New York City. Sex Transm Inf. 2011;87(4):344–8.CrossRefGoogle Scholar
  18. 18.
    King HL, Keller SB, Giancola MA, Rodriguez DA, Chau JJ, Young JA, et al. Pre-exposure prophylaxis accessibility research and evaluation (PrEPARE Study). AIDS Behav. 2014;18(9):1722–5.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Meyers K, Rodriguez K, Moeller RW, Gratch I, Markowitz M, Halkitis PN. High interest in a long-acting injectable formulation of pre-exposure prophylaxis for HIV in young men who have sex with men in NYC: a P18 cohort substudy. PLoS ONE. 2014;9(12):e114700.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Stack C, Oldenburg C, Mimiaga M, Elsesser SA, Krakower D, Novak DS, et al. Sexual behavior patterns and PrEP dosing preferences in a large sample of North American men who have sex with men. J Acquir Immune Defic Syndr. 2015;71(1):94–101.Google Scholar
  21. 21.
    McCormack S, Dunn DT, Desai M, Dolling DI, Gafos M, Gilson R, et al. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet. 2015;387(10013):53–60.CrossRefPubMedGoogle Scholar
  22. 22.
    Molina J, Capitant C, Spire B, Pialoux G, Chidiac C, Charreau I, et al. On demand PrEP with oral TDF-FTC in MSM: results of the ANRS Ipergay trial. In: Conference on retroviruses and opportunistic infections, Seattle, Washington, 2015.Google Scholar
  23. 23.
    Grosskopf NA, LeVasseur MT, Glaser DB. Use of the internet and mobile-based “apps” for sex-seeking among men who have sex with men in New York City. Am J Mens Health. 2014;8(6):510–20.CrossRefPubMedGoogle Scholar
  24. 24.
    Holloway IW, Rice E, Gibbs J, Winetrobe H, Dunlap S, Rhoades H. Acceptability of smartphone application-based HIV prevention among young men who have sex with men. AIDS Behav. 2014;18(2):285–96.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Winetrobe H, Rice E, Bauermeister J, Petering R, Holloway IW. Associations of unprotected anal intercourse with Grindr-met partners among Grindr-using young men who have sex with men in Los Angeles. AIDS Care. 2014;26(10):1303–8.CrossRefPubMedGoogle Scholar
  26. 26.
    Goedel WC, Duncan DT. Geosocial-networking app usage patterns of gay, bisexual, and other men who have sex with men: survey among users of Grindr, a mobile dating app. JMIR Public Health Surveill. 2015;1(1):e4.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Phillips G II, Magnus M, Kuo I, Rawls A, Peterson J, Jia Y, et al. Use of geosocial networking (GSN) mobile phone applications to find men for sex by men who have sex with men (MSM) in Washington, DC. AIDS Behav. 2014;18(9):1630–7.CrossRefPubMedGoogle Scholar
  28. 28.
    Beymer MR, Weiss RE, Bolan RK, Rudy ET, Bourque LB, Rodriguez JP, et al. Sex on demand: geosocial networking phone apps and risk of sexually transmitted infections among a cross-sectional sample of men who have sex with men in Los Angeles county. Sex Transm Inf. 2014;90(7):567–72.CrossRefGoogle Scholar
  29. 29.
    Landovitz RJ, Tseng C-H, Weissman M, Haymer M, Mendenhall B, Rogers K, et al. Epidemiology, sexual risk behavior, and HIV prevention practices of men who have sex with men using GRINDR in Los Angeles, California. J Urban Health. 2013;90(4):729–39.CrossRefPubMedGoogle Scholar
  30. 30.
    Holloway IW, Pulsipher CA, Gibbs J, Barman-Adhikari A, Rice E. Network influences on the sexual risk behaviors of gay, bisexual, and other men who have sex with men using geosocial networking applications. AIDS Behav. 2015;19(Suppl 2):112–22.CrossRefPubMedGoogle Scholar
  31. 31.
    Chayes M. NYC promotes acceptance of controversial HIV drug. Melville, New York: Newsday; 2014. http://www.newsday.com/news/new-york/nyc-promoting-acceptance-of-controversial-hiv-drug-1.9447395.
  32. 32.
    Newcomb ME, Mongrella MC, Weis B, McMillen SJ, Mustanski B. Partner disclosure of PrEP use and undetectable viral load on geosocial networking apps: frequency of disclosure and decisions about condomless sex. J Acquir Immune Defic Syndr. 2016;71(2):200–6.CrossRefPubMedGoogle Scholar
  33. 33.
    Duncan DT, Goedel WC, Stults CB, Brady WJ, Brooks FA, Blakely JS, et al. A study of intimate partner violence, substance abuse, and sexual risk behaviors among gay, bisexual, and other men who have sex with men in a sample of geosocial-networking smartphone application users. Am J Mens Health. 2016. doi:10.1177/1557988316631964.Google Scholar
  34. 34.
    Goedel WC, Halkitis PN, Duncan DT. Behavior- and partmer-based HIV risk perception and sexual risk behaviors in men who have sex with men (MSM) who use geosocial-networking smartphone applications in New York City. J Urban Health. 2016 (in Press).Google Scholar
  35. 35.
    Petersen MR, Deddens JA. A comparison of two methods for estimating prevalence ratios. BMC Med Res Methodol. 2008;8(1):9.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Blizzard L, Hosmer D. The log multinomial regression model for nominal outcomes with more than two attributes. Biom J. 2007;49(6):889–902.CrossRefPubMedGoogle Scholar
  37. 37.
    Barros AJ, Hirakata VN. Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol. 2003;3(1):21.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Liu AY, Kittredge PV, Vittinghoff E, Raymond HF, Ahrens K, Matheson T, et al. Limited knowledge and use of HIV post-and pre-exposure prophylaxis among gay and bisexual men. J Acquir Immune Defic Syndr. 2008;47(2):241–7.CrossRefPubMedGoogle Scholar
  39. 39.
    Mimiaga MJ, Case P, Johnson CV, Safren SA, Mayer KH. Pre-exposure antiretroviral prophylaxis (PrEP) attitudes in high risk Boston area MSM: limited knowledge and experience, but potential for increased utilization after education. J Acquir Immune Defic Syndr. 2009;50(1):77.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Weinberg J, Spinelli F, Bailey L, Halkitis PN, Jacobs D, Daskalakis D. Have condoms failed us? A community roundtable discussion. LGBT Health. 2014;1(4):242–9.CrossRefPubMedGoogle Scholar
  41. 41.
    Goedel WC, Halkitis PN, Greene RE, Hickson DA, Duncan DT. HIV risk behaviors, perceptions, and testing and pre-exposure prophylaxis (PrEP) awareness/use in Grindr-using men who have sex with men in Atlanta, Georgia. J Assoc Nurses AIDS Care. 2015;27(2):133–42.CrossRefPubMedGoogle Scholar
  42. 42.
    Governor Cuomo Announces Program to Protect High-Risk Individuals from HIV. New PrEP Assistance Program is the Latest Step in the Effort to End the Epidemic in New York State by the End of 2010 [press release]. Albany, New York: Office of the Governor of the State of New York 2015.Google Scholar
  43. 43.
    New York State Department of Health. 2015 Blueprint for Achieving the Goal Set Forth by Governor Cuomo to End the Epidemic in New York State by the End of 2020. Albany, New York: New York State Department of Health, 2015Google Scholar
  44. 44.
    Golub SA, Gamarel KE, Rendina HJ, Surace A, Lelutiu-Weinberger CL. From efficacy to effectiveness: facilitators and barriers to PrEP acceptability and motivations for adherence among MSM and transgender women in New York City. AIDS Patient Care STDs. 2013;27(4):248–54.CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    Cooper RD, Wiebe N, Smith N, Keiser P, Naicker S, Tonelli M. Systematic review and meta-analysis: renal safety of tenofovir disoproxil fumarate in HIV-infected patients. Clin Infect Dis. 2010;51(5):496–505.CrossRefPubMedGoogle Scholar
  46. 46.
    Adams J. Risk. London: Routledge; 1995.Google Scholar
  47. 47.
    Wilde G. Target risk: dealing with the danger of death, disease, and damage in everyday decision. Toronto: PDE; 1994.Google Scholar
  48. 48.
    Crepaz N, Hart TA, Marks G. Highly active antiretroviral therapy and sexual risk behavior: a meta-analytic review. JAMA. 2004;292(2):224–36.CrossRefPubMedGoogle Scholar
  49. 49.
    Kessler J, Myers JE, Nucifora KA, Mensah N, Toohey C, Khademi A, et al. Evaluating the impact of prioritization of antiretroviral pre-exposure prophylaxis in New York. AIDS. 2014;28(18):2683–91.CrossRefPubMedGoogle Scholar
  50. 50.
    Rendina HJ, Jimenez RH, Grov C, Ventuneac A, Parsons JT. Patterns of lifetime and recent HIV testing among men who have sex with men in New York City who use Grindr. AIDS Behav. 2014;18(1):41–9.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of Population Health, School of MedicineNew York UniversityNew YorkUSA
  2. 2.College of Global Public HealthNew York UniversityNew YorkUSA
  3. 3.Department of Sociology, College of Arts and ScienceNew York UniversityNew YorkUSA
  4. 4.Center for Drug Use and HIV Research, College of NursingNew York UniversityNew YorkUSA
  5. 5.Population Center, College of Arts and ScienceNew York UniversityNew YorkUSA
  6. 6.Center for Health, Identity, Behavior, and Prevention Studies, College of Global Public HealthNew York UniversityNew YorkUSA
  7. 7.Department of Medicine, School of MedicineNew York UniversityNew YorkUSA
  8. 8.Center for Data ScienceNew York UniversityNew YorkUSA

Personalised recommendations