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Willingness to Use HIV Pre-Exposure Prophylaxis Among Opiate Users

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Abstract

Few studies of pre-exposure prophylaxis (PrEP) to prevent HIV infection have focused on drug users. Between February to September 2013, we asked 351 opiate injectors entering detoxification treatment about HIV risk, knowledge about PrEP, and willingness to use a once daily PrEP pill under one of two randomly assigned effectiveness scenarios—40 % (low) or 90 % (high) effective in reducing HIV risk. Participants were 70 % male and 87 % non-Hispanic White. Only 7 % had heard of a drug to reduce HIV risk, yet once informed, 47 % would be willing to take such a pill [35 % of those in the low effectiveness scenario and 58 % in the high group (p < 0.001)]. Higher perceived HIV risk was associated with greater willingness to take medication. Increasing knowledge of PrEP and the rate of HIV reduction-effectiveness promised will influence its use among targeted high-risk drug users.

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References

  1. Hall HI, Song R, Rhodes P, et al. Estimation of HIV incidence in the United States. JAMA. 2008;300(5):520–9.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  2. Centers for Disease Control and Prevention. HIV Surveillance Report, 2008, vol 20 Atlanta, US, 2010.

  3. Prejean J, Song R, Hernandez A, et al. Estimated HIV incidence in the United States, 2006–2009. PLoS One. 2011;6(8):e17502.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. Coyle SL, Needle RH, Normand J. Outreach-based HIV prevention for injecting drug users: a review of published outcome data. Public Health Rep. 1998;113(Suppl 1):19–30.

    PubMed Central  PubMed  Google Scholar 

  5. Metzger DS, Navaline H. HIV prevention among injection drug users: the need for integrated models. J Urban Health. 2003;80(43):59–66.

    Google Scholar 

  6. Vlahov D, Junge B. The role of needle exchange programs in HIV prevention. Public Health Rep. 1998;113(Suppl 1):75–80.

    PubMed Central  PubMed  Google Scholar 

  7. Avins AL, Lindan CP, Woods WJ, et al. Changes in HIV-related behaviors among heterosexual alcoholics following addiction treatment. Drug Alcohol Depend. 1997;44(1):47–55.

    Article  CAS  PubMed  Google Scholar 

  8. Gossop M, Marsden J, Stewart D, Treacy S. Reduced injection risk and sexual risk behaviours after drug misuse treatment: results from the National Treatment Outcome Research Study. AIDS Care. 2002;14(1):77–93.

    Article  CAS  PubMed  Google Scholar 

  9. Baeten JM, Donnell D, Ndase P, et al. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012;367(5):399–410.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. 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.

  11. Update to Interim Guidance for Preexposure Prophylaxis. (PrEP) for the Prevention of HIV Infection: prEP for injecting drug users. MMWR Morb Mortal Wkly Rep. 2013;62(23):463–5.

    Google Scholar 

  12. Grant RM, Lama JR, Anderson PL, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–99.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  13. Marrazzo JM, Ramjee G, Nair G, et al., editors. Pre-exposure prophylaxis for HIV in women: daily oral tenofovir, oral tenofovir-emtricitabine, or vaginal tenofovir gel in the VOICE Study (MTN 003). The 20th Conference on Retroviruses and Opportunistic Infections (CROI 2013); 2013; Atlanta, GA.

  14. Mayer KH, Mimiaga MJ, Gelman M, Grasso C. Raltegravir, tenofovir DF, and emtricitabine for postexposure prophylaxis to prevent the sexual transmission of HIV: safety, tolerability, and adherence. J Acquir Immune Defic Syndr. 2012;59(4):354–9.

    Article  CAS  PubMed  Google Scholar 

  15. Thigpen MC, Kebaabetswe PM, Paxton LA, et al. Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana. N Engl J Med. 2012;367(5):423–34.

    Article  CAS  PubMed  Google Scholar 

  16. Van Damme L, Corneli A, Ahmed K, et al. Preexposure prophylaxis for HIV infection among African women. N Engl J Med. 2012;367(5):411–22.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Choopanya K, Martin M, Suntharasamai P, et al. Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2013;381(9883):2083–90.

    Article  PubMed  Google Scholar 

  18. Baral SD, Stromdahl S, Beyrer C. The potential uses of preexposure prophylaxis for HIV prevention among people who inject drugs. Curr Opin HIV AIDS. 2012;7(6):563–8.

    Article  PubMed  Google Scholar 

  19. Substance Abuse and Mental Health Services Administration. Results from the 2007 National Survey on Drug Use and Health: National findings. NSDUH Series H-34 DHHS Publication No. SMA 08-4343 ed. Rockville: Office of Applied Studies; 2008.

  20. Stein MD, O’Sullivan PS, Ellis P, Perrin H, Wartenberg A. Utilization of medical services by drug abusers in detoxification. J Subst Abuse. 1993;5(2):187–93.

    Article  CAS  PubMed  Google Scholar 

  21. Substance Abuse and Mental Health Services Administration. The DASIS Report: Admissions for detoxification, 2001. Rockville: Office of Applied Studies; 2004.

    Google Scholar 

  22. Center for Substance Abuse Treatment. TIP 19: Detoxification From Alcohol and Other Drugs: Treatment Improvement Protocol (TIP) Series 19; DHHS Publication No. (SMA) 95-3046. SAMHSA/CSAT Treatment Improvement Protocols. Rockville: Substance Abuse and Mental Health Services Administration; 1995.

  23. Substance Abuse and Mental Health Services Administration. Results from the 2006 National Survey on Drug Use and Health: National Findings. NSDUH H-32 DHHS Publication No. SMA 07-4293 ed. Rockville: Office of Applied Studies; 2007.

  24. Barash EA, Golden M. Awareness and use of HIV pre-exposure prophylaxis among attendees of a seattle gay pride event and sexually transmitted disease clinic. AIDS Patient Care STDS. 2010;24(11):689–91.

    Article  PubMed  Google Scholar 

  25. 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.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Smith DK, Toledo L, Smith DJ, Adams MA, Rothenberg R. Attitudes and program preferences of african-american urban young adults about pre-exposure prophylaxis (PrEP). AIDS Educ Prev. 2012;24(5):408–21.

    Article  PubMed  Google Scholar 

  27. Brooks RA, Kaplan RL, Lieber E, Landovitz RJ, Lee SJ, Leibowitz AA. Motivators, concerns, and barriers to adoption of preexposure prophylaxis for HIV prevention among gay and bisexual men in HIV-serodiscordant male relationships. AIDS Care. 2011;23(9):1136–45.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Liu AY, Kittredge PV, Vittinghoff E, 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.

    Article  PubMed  Google Scholar 

  29. Mansergh G, Koblin BA, Colfax GN, McKirnan DJ, Flores SA, Hudson SM. Preefficacy use and sharing of antiretroviral medications to prevent sexually-transmitted HIV infection among US men who have sex with men. J Acquir Immune Defic Syndr. 2010;55(2):e14–6.

    Article  PubMed  Google Scholar 

  30. Mimiaga MJ, Case P, Johnson CV, Safren SA, Mayer KH. Preexposure antiretroviral prophylaxis attitudes in high-risk Boston area men who report having sex with men: limited knowledge and experience but potential for increased utilization after education. J Acquir Immune Defic Syndr. 2009;50(1):77–83.

    Article  PubMed Central  PubMed  Google Scholar 

  31. 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 Infect. 2011;87(4):344–8.

    Article  PubMed  Google Scholar 

  32. Wingood GM, Dunkle K, Camp C, et al. Racial differences and correlates of potential adoption of preexposure prophylaxis: results of a national survey. J Acquir Immune Defic Syndr. 2013;63(1):S95–101.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Malta M, Magnanini MM, Strathdee SA, Bastos FI. Adherence to antiretroviral therapy among HIV-infected drug users: a meta-analysis. AIDS Behav. 2010;14(4):731–47.

    Article  PubMed  Google Scholar 

  34. Whiteside YO, Harris T, Scanlon C, Clarkson S, Duffus W. Self-perceived risk of HIV infection and attitudes about preexposure prophylaxis among sexually transmitted disease clinic attendees in South Carolina. AIDS Patient Care STDS. 2011;25(6):365–70.

    Article  PubMed  Google Scholar 

  35. Aghaizu A, Mercey D, Copas A, Johnson AM, Hart G, Nardone A. Who would use PrEP? Factors associated with intention to use among MSM in London: a community survey. Sex Transm Infect; 2012.

  36. Ajzen I, Fishbein M. Understanding attitudes and predicting social behavior. Englewood Cliffs: Prentice Hall; 1980.

    Google Scholar 

  37. Fisher WA, Fisher JD, Rye BJ. Understanding and promoting AIDS-preventive behavior: insights from the theory of reasoned action. Health Psychol. 1995;14(3):255–64.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This study was funded by the National Institute on Drug Abuse (RO1 DA034261). Dr. Stein is a recipient of a NIDA Mid-Career Investigator Award (K24 DA00512).

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Correspondence to Michael Stein.

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Stein, M., Thurmond, P. & Bailey, G. Willingness to Use HIV Pre-Exposure Prophylaxis Among Opiate Users. AIDS Behav 18, 1694–1700 (2014). https://doi.org/10.1007/s10461-014-0778-z

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