Factors Associated with Pre-exposure Prophylaxis in a Highly Insured Population of Urban Men Who Have Sex with Men, 2014
In the United States, an estimated 25% of men who have sex with men (MSM) have indications for receiving pre-exposure prophylaxis to prevent HIV infection (PrEP), but <4% reported PrEP use in the past 12 months. We evaluate factors associated with having heard of, willingness to use, and use of PrEP in a venue-based, time-spaced sample of 316 urban, highly insured Boston MSM in the 2014 NHBS. We found that 53.7% of respondents reported receiving usual medical care from a doctor’s office or health maintenance organization, 57.6% had an indication for PrEP, 66.6% had heard of PrEP, 53.6% reported willingness to use PrEP, and 5.8% reported use of PrEP in the past 12 months. In multivariable analyses, an indication for PrEP was statistically associated with having heard of, willingness to use and use of PrEP in the past 12 months. Findings guide statewide efforts to evaluate and promote PrEP.
KeywordsPre-exposure prophylaxis Men who have sex with men HIV prevention Epidemiology Behavioral surveillance
Mientras que el 25% de los hombres homosexuales en Estados Unidos pueden tener una indicación para tomar profilaxis pre exposición a VIH (PrEP), <4% reportan su uso. Entrevistamos a 316 hombres homosexuales en la ciudad de Boston, donde el >97% de la población tiene seguro de salud. Los resultados indican que 57.6% de los participantes tenían alguna indicación para PrEP, que 66.6% tenía conocimiento de la disponibilidad de PrEP, que 53.6% estaba dispuesta a tomar PrEP y 5.8% usó PrEP en los últimos 12 meses. El análisis multifactorial encontró que había una asociación significativa entre tener una indicación para PrEP y el conocimiento, la disposición a tomarlo, y el uso de PrEP. Estos hallazgos sirven para evaluar y promover el uso de PrEP en Massachusetts para lograr una reducción de 30% en el número de diagnósticos nuevos de VIH en hombres homosexuales antes del 2021.
Field components were conducted by Chris Wittke and Justin Hinchey of the AIDS Action Committee of Massachusetts. This study was funded by the Centers for Disease Control and Prevention Cooperative Agreement No. U1BPS003254-05.
Compliance with Ethical Standards
Conflict of interest
All authors declare that they have no conflicts of interest: Klevens, Doherty, Fukuda, Cranston and DeMaria were employees of the Massachusetts Department of Public Health. Author Martin was an employee of non-profit Boston University and received no additional funding for this project.
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. Protocol was reviewed and approved by the Massachusetts Department of Public Health Institutional Review Board.
Informed consent was obtained from all individual participants included in the study using instruments in English and Spanish; consent forms were approved by the Massachusetts Department of Public Health Institutional Review Board.
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