Predictors of PrEP Uptake Among Patients with Equivalent Access
Increasing PrEP adoption for eligible individuals is critical, but limited research has examined individual-level factors that might be amenable to educational or behavioral intervention. Using data from a PrEP demonstration project conducted at a community health center, we examined differences in behavioral and psychosocial factors between patients offered PrEP who chose to accept it and those who declined. In a multivariable model, the odds of accepting PrEP were higher among those with an HIV-positive main partner, greater risk behavior in the past 3 months, and higher HIV risk perception. PrEP adoption was positively associated with PrEP adherence self-efficacy and negatively associated with perceived sensitivity to medicines. These psychological variables were associated with measures of PrEP- and HIV-related stigma. In the multivariable model, there were no differences in PrEP adoption by demographic factors or socioeconomic status. Data suggest that patients’ decisions about PrEP uptake may be impacted not only by objective and subjective HIV risk, but also by psychological variables such as stigma beliefs, medication beliefs, and self-efficacy.
KeywordsPre-exposure prophylaxis (PrEP) HIV prevention Implementation Stigma Self-efficacy
This research was funded by Grant R01AA022067 from the National Institute of Alcohol Abuse and Alcoholism (S.A. Golub, PI). We gratefully acknowledge the hard work of Amy Hilley, Anthony Catalanotti, Sharon Marazzo, Machel Hunt, Nora Douglas, Kailip Boonrai, Anthony Surace, and Dr. Kristi Gamarel. We also thank the participants who gave their time and energy to SPARK.
This study was funded by the National Institute of Alcohol Abuse and Alcoholism (R01AA022067).
Compliance with Ethical Standards
Conflict of interest
Sarit Golub received study drug for use in this research from Gilead Sciences. Rachel Fikslin declares she has no conflict of interest. Matthew Goldberg declares he has no conflict of interest. Stephanie Peña declares she has no conflict of interest. Asa Radix declares he has no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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