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AIDS and Behavior

, Volume 21, Issue 5, pp 1376–1382 | Cite as

Use of Pre-exposure Prophylaxis (PrEP) in Young Men Who Have Sex with Men is Associated with Race, Sexual Risk Behavior and Peer Network Size

  • Lisa M. KuhnsEmail author
  • Anna L. Hotton
  • John Schneider
  • Robert Garofalo
  • Kayo Fujimoto
Brief Report

Abstract

Pre-exposure prophylaxis (PrEP) is efficacious to prevent HIV infection, however, uptake among young men who have sex with men (YMSM) is relatively low. The purpose of this study was to describe PrEP use and related factors in a representative sample of YMSM in two cities, Chicago and Houston. YMSM, ages 16–29, were recruited via respondent-driven sampling (RDS) from 2014 to 2016. Correlates of PrEP uptake were assessed in weighted multivariable logistic regression models. A total of 12.2% of participants (of 394) reported ever taking PrEP; Black YMSM had the lowest rates of uptake (4.7%) and Whites the highest (29.5%). In a multivariable regression model, having an HIV positive sex partner, reporting recent group sex, peer network size, and city (Chicago) were significantly and positively associated with use of PrEP, while Black race was negatively associated with it. Given evidence of racial/ethnic disparities in PrEP uptake in this study, further research is needed to identify potential mechanisms of action and points of intervention.

Keywords

Pre-exposure prophylaxis Young men who have sex with men Social network HIV prevention 

Resumen

Profilaxis prexposición (PrEP) es eficaz para prevenir la infección por el VIH, sin embargo, la captación entre los hombres jóvenes que tienen relaciones sexuales con hombres (YMSM) es relativamente baja. El propósito de este estudio fue describir el uso de PrEP y factores relacionados en una muestra representativa de YMSM en dos ciudades, Chicago y Houston. YMSM, edades 16–29, fueron reclutados a través de respondent-driven sampling (RDS) desde 2014–2016. Los correlatos de la captación de PrEP se evaluaron en modelos de regresión logística multivariable. Un total de 12.2% de los participantes (de 394) haber tomado PrEP; Black YMSM tuvo las tasas más bajas (4.7%) y los blancos el más alto (29.5%). En un modelo de regresión multivariable, tener una pareja sexual positiva para el VIH, reportar sexo en grupo reciente, tamaño de la red de pares y ciudad (Chicago) se asociaron significativa y positivamente con el uso de PrEP, mientras que la raza negra se asoció negativamente con ella. Dada la evidencia de las disparidades raciales/étnicas en la captación de PrEP en este estudio, se necesitan más investigaciones para identificar posibles mecanismos de acción y puntos de intervención.

Notes

Acknowledgements

We thank members of the Young Men’s Affiliation Project (YMAP) Team in Chicago and Houston for their contribution to sample accrual and data collection.

Funding

Research reported in this publication was supported by the National Institute of Mental Health and the National Institute of General Medical Sciences of the National Institutes of Health under Award Numbers R01MH100021 (MPI: K. Fujimoto, J. Schneider) and R21GM113694 (PI: K. Fujimoto). This study was also supported, in part, by Gilead Sciences, Inc. (PI: K. Fujimoto). The project described was also supported, in part, by the Northwestern University Clinical and Translational Science Institute, Grant Number UL1TR000150 from the National Center for Advancing Translational Sciences, Clinical and Translational Sciences Award (CTSA). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The CTSA is a registered trademark of the U.S. Department of Health and Human Services (DHHS).

Compliance with Ethical Standards

Conflicts of interest

Authors L.Kuhns, J. Schneider, and K.Fujimoto have received research grants from Gilead Sciences, Inc. Author R. Garofalo has received speaker honoraria from Gilead Sciences, Inc. Author A. Hotton declares no conflicts of interest.

Ethical Approval

All procedures performed involving human participants were in accordance with the ethical standards of the institutional review boards at the participating institutions and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants involved in this study.

References

  1. 1.
    Grant RM, Anderson PL, McMahan V, Liu A, Amico KR, Mehrotra M, et al. Uptake of pre-exposure prophylaxis, sexual practices, and HIV incidence in men and transgender women who have sex with men: a cohort study. Lancet Infect Dis. 2014;14(9):820–9.CrossRefPubMedGoogle Scholar
  2. 2.
    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. New Eng J Med. 2010;363(27):2587–99.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Centers for Disease Control and Prevention. Diagnoses of HIV infection among adolescents and young adults in the United States and 6 dependent areas, 2010–2014. HIV Surveillance Supplemental Report 2016. 2016;21(3).Google Scholar
  4. 4.
    Hosek SG, Siberry G, Bell M, Lally M, Kapogiannis B, Green K, et al. The acceptability and feasibility of an HIV preexposure prophylaxis (PrEP) trial with young men who have sex with men. J Acquir Immune Defic Syndr. 2013;62(4):447–56.CrossRefPubMedGoogle Scholar
  5. 5.
    Holloway I, Dougherty R, Gildner J, Beougher SC, Pulsipher C, Montoya JA, et al. PrEP uptake, adherence, and discontinuation among california YMSM using geosocial networking applications. J Acquir Immune Defic Syndr. 2016;74:15–20.CrossRefGoogle Scholar
  6. 6.
    Khanna AS, Michaels S, Skaathun B, Morgan E, Green K, Young L, et al. Preexposure prophylaxis wwareness and use in a population-based sample of young black men who have sex with men. JAMA Intern Med. 2016;176(1):136–8.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Strauss BB, Greene GJ, Phillips G 2nd, Bhatia R, Madkins K, Parsons JT, et al. Exploring patterns of awareness and use of HIV pre-exposure prophylaxis among young men who have sex with men. AIDS Behav. 2016;. doi: 10.1007/s10461-016-1480-0.Google Scholar
  8. 8.
    Khanna AS, Schumm P, Schneider JA. Facebook network structure and awareness of preexposure prophylaxis among young men who have sex with men. Ann Epidemiol. 2016;. doi: 10.1016/j.annepidem.2016.11.006.PubMedGoogle Scholar
  9. 9.
    Bush S, Magnuson D, Rawlings M, Hawkins T, McCallister S, Mera Giler R. Racial characteristics of FTC/TDF for pre-exposure prophylaxis users in the U.S. American Society for Micobiology (ASM); June 16–20; Boston, 2016.Google Scholar
  10. 10.
    Hoots BE, Finlayson T, Nerlander L, Paz-Bailey G. Willingness to take, use of, and indications for pre-exposure prophylaxis among men who have sex with men-20 US Cities, 2014. Clin Infect Dis. 2016;63(5):672–7.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Pulsipher CA, Montoya JA, Plant A, Curtis P, Holloway IW, Leibowitz AA. Addressing PrEP disparities among young gay and bisexual men in California. Los Angeles: California HIV/AIDS Res Prog.; 2016.Google Scholar
  12. 12.
    Fujimoto K, Wang P, Kuhns LM, Ross MW, Williams ML, Garofalo R, et al. Multiplex competition, collaboration, and funding networks among health and social organizations: towards organization-based HIV interventions for young men who have sex with men. Med Care. 2016;55(2):102–10.CrossRefGoogle Scholar
  13. 13.
    Heckathorn DD. Respondent-driven sampling: a new approach to the study of hidden populations. Soc Probl. 1997;44(2):174–99.CrossRefGoogle Scholar
  14. 14.
    United States Department of Health and Human Resources. State by state 2016 [cited 2016 September 12]. https://www.hhs.gov/healthcare/facts-and-features/state-by-state/.
  15. 15.
    Volz EW, C.; Cameron, C.; Spiller, M.; Barash, V.; Degani, I.; and Heckathorn, D.D. Respondent-Driven Sampling Analysis Tool (RDSAT). 7.1 ed. Ithaca, NY: Cornell University; 2012.Google Scholar
  16. 16.
    Levy ME, Wilton L, Phillips G 2nd, Glick SN, Kuo I, Brewer RA, et al. Understanding structural barriers to accessing HIV testing and prevention services among black men who have sex with men (BMSM) in the United States. AIDS Behav. 2014;18(5):972–96.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Garofalo R, Hotton AL, Kuhns LM, Gratzer B, Mustanski B. Incidence of HIV infection and sexually transmitted infections and related risk factors among very young men who have sex with men. J Acquir Immune Defic Syndr. 2016;72(1):79–86.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Lisa M. Kuhns
    • 1
    • 2
    Email author
  • Anna L. Hotton
    • 3
  • John Schneider
    • 4
    • 5
    • 6
  • Robert Garofalo
    • 1
    • 2
  • Kayo Fujimoto
    • 7
  1. 1.Division of Adolescent MedicineAnn & Robert H. Lurie Children’s HospitalChicagoUSA
  2. 2.Department of Pediatrics, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  3. 3.Division of Epidemiology & BiostatisticsUniversity of Illinois at Chicago School of Public HealthChicagoUSA
  4. 4.Chicago Center for HIV EliminationUniversity of ChicagoChicagoUSA
  5. 5.Department of MedicineUniversity of ChicagoChicagoUSA
  6. 6.Department of Public Health SciencesUniversity of ChicagoChicagoUSA
  7. 7.Department of Health Promotion & Behavioral Sciences, School of Public HealthThe University of Texas Health Science Center at HoustonHoustonUSA

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