Skip to main content

Advertisement

SpringerLink
Log in

PrEP Use and Correlates of Use Among a Large, Urban Sample of Men and Transgender Persons Who Have Sex with Men

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

We examined recent pre-exposure prophylaxis (PrEP) use (past 6 months) and its correlates among a large sample of men who have sex with men and transgender and gender non-conforming persons participating in a home HIV self-testing program conducted by the New York City Health Department between 11/2016 and 1/2017. Correlates examined included demographic characteristics and HIV-related behaviors in the past 6 months. Associations with recent PrEP use were assessed using log-binomial regression. 400 (22.5%) of 1776 participants reported recent PrEP use. In adjusted models, recent PrEP use was associated with Manhattan residence [adjusted prevalence ratio (aPR) 1.26; 95% confidence interval (CI) (1.04, 1.53)], higher income [aPR 1.29; 95% CI (1.03, 1.62)], and having insurance [aPR 1.89; 95% CI (1.33, 2.69)]. All HIV-related behaviors, except for injection drug use, were individually associated with PrEP use. More research is needed to better understand barriers to PrEP use among patients who are low income and/or uninsured as this may help improve current public health efforts to increase PrEP uptake among disproportionately impacted populations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. HIV Epidemiology and Field Services Program. HIV Surveillance Annual Report, 2019. New York City Department of Health and Mental Hygiene: New York, NY. 2020.

  2. Becasen J, Denard C, Mullins M, Higa D, Sipe T. Estimating the prevalence of HIV and sexual behaviors among the US transgender population: a systematic review and meta-analysis, 2006–2017. Am J Public Health. 2019;109(1):e1–8.

    Article  Google Scholar 

  3. HIV.gov. FDA approves first drug for reducing the risk of sexually acquired HIV infection. https://www.hiv.gov/blog/fda-approves-first-drug-for-reducing-the-risk-of-sexually-acquired-hiv-infection. Accessed 30 Nov 2017.

  4. CDC.gov. Preexposure prophylaxis for the prevention of HIV infection in the United States – 2017 Update: A Clinical Practice Guideline. https://www.cdc.gov/hiv/pdf/risk/prep/cdc-hiv-prep-guidelines-2017.pdf. Accessed 18 Feb 2019.

  5. Finlayson T, Cha S, Xia M, et al. Changes in HIV preexposure prophylaxis awareness and use among men who have sex with men—20 Urban Areas, 2014 and 2017. MMWR Morb Mortal Wkly Rep. 2019;68(27):597–603.

    Article  Google Scholar 

  6. Scanlin K, Edelstein Z, Findlater C, Salcuni P, Daskalakis D, Myers J. Trends in PrEP awareness and use and associations with use among men who have sex with men, New York City, 2012–2016. Presented at: International Conference on HIV Treatment and Prevention Adherence (Abstract Number 184); 2017 June 4–6; Miami, FL, USA.

  7. NYC.gov. Ending the epidemic overview. https://www1.nyc.gov/assets/doh/downloads/pdf/ah/ete-strategy.pdf. Accessed 23 Nov 2018.

  8. Okafor C, Gorbach P, Ragsdale A, Quinn B, Shoptaw S. Correlates of preexposure prophylaxis (PrEP) Use among men who have sex with men (MSM) in Los Angeles, California. J Urban Health. 2017;94(5):710–5.

    Article  Google Scholar 

  9. Highleyman L. https://www.aidsmap.com/news/jun-2016/prep-use-rising-fast-us-large-racial-disparities-remain. Accessed 3 Nov 2017.

  10. Snowden J, Chen Y, McFarland W, Raymond H. Prevalence and characteristics of users of pre-exposure prophylaxis (PrEP) among men who have sex with men, San Francisco, 2014 in a cross-sectional survey: implications for disparities. Sex Transm Infect. 2016;93(1):52–5.

    Article  Google Scholar 

  11. Kanny D, Jeffries WL IV, Chapin-Bardales J, et al. Racial/ethnic disparities in HIV preexposure prophylaxis among men who have sex with men — 23 Urban Areas, 2017. MMWR Morb Mortal Wkly Rep. 2019;68(37):801–6.

    Article  Google Scholar 

  12. Edelstein Z, Newton-Dame R, Myers J, Salcuni P, Jacobson L. Pre-exposure prophylaxis (PrEP) in ambulatory care practices, New York City, 2012–2014. Presented at: International Conference on HIV Treatment and Prevention Adherence (Abstract Number 126); 2015 June 28–30, Miami, FL, USA.

  13. Salcuni P, Smolen J, Jain S, Myers J, Edelstein Z. Trends and associations with PrEP prescription among 602 New York City (NYC) ambulatory care practices, 2014–2016. Open Forum Infect Dis. 2017;4(Suppl 1):S21.

    Article  Google Scholar 

  14. Edelstein Z, Wahnich A, Purpura L, et al. Five waves of an online HIV self-test giveaway in New York City, 2015 to 2018. Sex Transm Dis. 2020;47(5S suppl 1):S41–7.

    Article  Google Scholar 

  15. Giorgetti R, Tagliabracci A, Schifano F, Zaami S, Marinelli E, Busardò F. When, “Chems” meet sex: a rising phenomenon called “ChemSex.” Curr Neuropharmacol. 2017;15(5):762–70.

    Article  CAS  Google Scholar 

  16. Maxwell S, Shahmanesh M, Gafos M. Chemsex behaviours among men who have sex with men: a systematic review of the literature. Int J Drug Policy. 2019;63:74–89.

    Article  Google Scholar 

  17. van Dijk M, de Wit J, Guadamuz T, Martinez J, Jonas K. Slow uptake of PrEP: behavioral predictors and the influence of price on PrEP uptake among MSM with a high interest in PrEP. AIDS Behav. 2021;25:2382.

    Article  Google Scholar 

  18. Vail R. PrEP to prevent HIV and promote sexual health. https://www.hivguidelines.org/prep-for-prevention/prep/#tab_2. Accessed 25 Nov 2019.

  19. Scanlin K, Mensah N, Salcuni P, Myers J, Daskalakis D, Edelstein Z. Increasing PrEP use among men who have sex with men, New York City, 2013–2015. Presented at: Conference on Retroviruses and Opportunistic Infections (Abstract Number 888); 2016 February 22–25, Boston, MA, USA.

  20. Patel R, Mena L, Nunn A, et al. Impact of insurance coverage on utilization of pre-exposure prophylaxis for HIV prevention. PLoS ONE. 2017;12(5):e0178737.

    Article  Google Scholar 

  21. NYC.gov. Payment Options For Pre-Exposure Prophylaxis (PrEP). https://www1.nyc.gov/assets/doh/downloads/pdf/csi/csi-prep-pep-payment-options-sheet.pdf. Accessed 23 Nov 2018.

  22. Corbin-Gutierrez E, Carson E, Ma M. Paying for PrEP: insurance and benefits navigation. Presented at: Biomedical HIV Prevention Summit; 2017 December 4–5, New Orleans, LA, USA.

  23. NYC.gov. PrEP and PEP Action Kit. https://www1.nyc.gov/site/doh/providers/resources/public-health-action-kits-prep-pep.page

  24. Myers J, Merges A, Saleh L, et al. Building a citywide network for prevention navigation: year one of New York City’s playsure network. Presented at: National HIV Prevention Conference (Abstract Number 5755); 2019 March 18–21, Atlanta, GA, USA.

  25. Myers J, Edelstein Z, Daskalakis D, et al. Preexposure prophylaxis monitoring in New York City: a public health approach. Am J Public Health. 2018;108(S4):S251–7.

    Article  Google Scholar 

  26. NYC.gov. Where to Get PrEP and PEP in New York City. https://www1.nyc.gov/site/doh/health/health-topics/prep-pep-resources.page. Accessed 13 Mar 2018.

  27. NYC.gov. Be Sure, Play Sure, Stay Sure. https://www1.nyc.gov/site/doh/health/health-topics/hiv-besure-playsure-staysure.page. Accessed 13 Mar 2018.

  28. NYC.gov. PlaySure Network for HIV Prevention. https://www1.nyc.gov/site/doh/providers/resources/playsure-network.page. Accessed 13 Mar 2018.

  29. Myers J, Braunstein S, Edelstein Z, Rivera A, Motanya N, Blackstock O. Development of a PrEP equity index to set local targets for PrEP coverage. Presented at: Conference on Retroviruses and Opportunistic Infections (Abstract Number 1005); 2020 March 8–11, Boston, MA, USA.

  30. Fauci A, Redfield R, Sigounas G, Weahkee M, Giroir B. Ending the HIV epidemic: a plan for the United States. JAMA. 2019;321(9):844–5.

    Article  Google Scholar 

Download references

Acknowledgements

The authors would like to acknowledge the study participants as well as the New York City Department of Health and Mental Hygiene Epi Scholars program.

Funding

This work was supported by the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention of the Centers for Disease Control and Prevention (PS12-1201 and PS18-1802). Lawrence Purpura was supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health under Award Number T32AI114398. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author information

Author notes

  1. Dinesh Rathakrishnan and Lawrence J. Purpura are co-first authors.

Authors and Affiliations

  1. New York City Department of Health and Mental Hygiene, Queens, NY, USA

    Dinesh Rathakrishnan, Lawrence J. Purpura, Paul M. Salcuni, Julie E. Myers, Amanda Wahnich, Demetre C. Daskalakis & Zoe R. Edelstein

  2. Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA

    Dinesh Rathakrishnan & Zoe R. Edelstein

  3. Division of Infectious Diseases, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, 630 West 168th Street, New York, NY, 10032, USA

    Lawrence J. Purpura & Julie E. Myers

  4. ICAP, Columbia University Mailman School of Public Health, New York, NY, USA

    Lawrence J. Purpura

Authors
  1. Dinesh Rathakrishnan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lawrence J. Purpura
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paul M. Salcuni
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Julie E. Myers
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Amanda Wahnich
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Demetre C. Daskalakis
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Zoe R. Edelstein
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lawrence J. Purpura.

Ethics declarations

Conflict of interest

The authors have no other relevant financial or non-financial interests to disclose.

Ethical Approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the New York City Department of Health and Mental Hygiene Institutional Review Board.

Informed Consent

Documented informed consent was waived by the New York City Department of Health and Mental Hygiene Institutional Review Board due to the collection of deidentified data only.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rathakrishnan, D., Purpura, L.J., Salcuni, P.M. et al. PrEP Use and Correlates of Use Among a Large, Urban Sample of Men and Transgender Persons Who Have Sex with Men. AIDS Behav 26, 1017–1025 (2022). https://doi.org/10.1007/s10461-021-03456-w

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-021-03456-w

Keywords

Search

Navigation