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Factors Associated with Awareness of Pre-exposure Prophylaxis for HIV Among Persons Who Inject Drugs in Philadelphia: National HIV Behavioral Surveillance, 2015

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Abstract

Persons who inject drugs (PWID) continue to experience disproportionate HIV burden. Though studies demonstrate PWID find pre-exposure prophylaxis (PrEP) acceptable, awareness and uptake remains low. Data from the 2015 PWID cycle of the National HIV Behavioral Surveillance (n = 612) in Philadelphia, Pennsylvania (USA) were analyzed to evaluate how socio-demographics and behavioral factors impact PrEP awareness. Only 12.4% of PWID surveyed were PrEP-aware and 2.6% reported receiving a prescription. Factors associated with PrEP awareness included having at least some college education (aOR 2.13, 95% CI 1.03, 4.43), sharing paraphernalia (aOR 2.37, 95% CI 1.23, 4.56), obtaining syringes/needles primarily from a syringe exchange program (aOR 2.28, 95% CI 1.35, 3.87), STI testing (aOR 1.71, 95% CI 1.01, 2.89) and drug treatment (aOR 2.81, 95% CI 1.62, 4.87). Accessing prevention and health services increased the odds of being PrEP-aware; however, awareness was low overall. Additional promotion efforts are warranted.

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References

  1. Lansky A, Finlayson T, Johnson C, et al. Estimating the number of persons who inject drugs in the united states by meta-analysis to calculate national rates of HIV and hepatitis C virus infections. PLoS ONE. 2014;9(5):e97596.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Centers for Disease Control and Prevention. Estimated HIV incidence and prevalence in the United States, 2010–2015. HIV Surveillance Supplemental Report 2018; 23(No. 1). http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html. Published March 2018. Accessed 28 July 2018.

  3. Centers for Disease Control and Prevention. HIV Surveillance Report, 2016; vol. 28. http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html. Published November 2017. Accessed 28 July 2018.

  4. Bastos FI, Strathdee SA. Evaluating effectiveness of syringe exchange programmes: current issues and future prospects. Soc Sci Med. 2000;51(12):1771–82.

    Article  CAS  PubMed  Google Scholar 

  5. Gibson DR, Flynn NM, Perales D. Effectiveness of syringe exchange programs in reducing HIV risk behavior and HIV seroconversion among injecting drug users. AIDS. 2001;15(11):1329–41.

    Article  CAS  PubMed  Google Scholar 

  6. Aspinall EJ, Nambiar D, Goldberg DJ, et al. Are needle and syringe programmes associated with a reduction in HIV transmission among people who inject drugs: a systematic review and meta-analysis. Int J Epidemiol. 2014;43(1):235–48.

    Article  PubMed  Google Scholar 

  7. Centers for Disease Control and Prevention. Preexposure prophylaxis for the prevention of HIV infection in the United States—2014: a clinical practice guideline. https://www.cdc.gov/hiv/pdf/guidelines/PrEPguidelines2014.pdf. Accessed [17 June 2018.

  8. Substance Abuse and Mental Health Administration, Center for Behavioral Health Statistics and Quality. The DAWN report: highlights of the 2010 drug abuse warning network (DAWN) findings on drug-related emergency department visits. Rockville, MD: 2012. https://www.samhsa.gov/data/sites/default/files/DAWN096/DAWN096/SR096EDHighlights2010.pdf. Accessed 2 May 2018.

  9. Ciccarone D. Heroin in brown, black and white: Structural factors and medical consequences in the US heroin market. Int J Drug Policy. 2009;20(3):277–82.

    Article  PubMed  Google Scholar 

  10. U.S. Department of Justice, National Drug Intelligence Center. Philadelphia/Camden high intensity drug trafficking area drug market analysis 2011. Washington, D.C.: 2011. https://www.justice.gov/archive/ndic/dmas/Philadelphia-Camden_DMA-2011(U).pdf. Accessed 2 May 2018.

  11. City of Philadelphia. Executive Order No. 4-92. Philadelphia, PA: 1992. https://www.justice.gov/archive/ndic/dmas/Philadelphia-Camden_DMA-2011(U).pdf. Accessed 2 May 2018.

  12. Prevention Point Philadelphia. History of PPP. 2016. https://ppponline.org/about-us/history-ppp. Accessed 4 December 2017.

  13. Philadelphia Department of Public Health. AIDS activities coordinating office surveillance report, 2016. Philadelphia, PA: AIDS Activities Coordinating Office, Department of Public Health, 2016. https://www.phila.gov/health/pdfs/aaco/HIV%20Surveillance%20Report-2016web.pdf. Accessed 2 May 2018.

  14. 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 

  15. 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  PubMed Central  Google Scholar 

  16. MRC Clinical Trials Unit. The PROUD study: examining the impact on gay men of using pre-exposure prophylaxis (PrEP), study results, key messages, questions and answers. University College London, February 24, 2015. http://www.proud.mrc.ac.uk/results/.

  17. Molina J-M, Capitant C, Spire B, Pialoux G, Chidiac C, Charreau I. On demand PrEP with oral TDF-FTC in MSM: results of the ANRS Ipergay trial [23LB]. Presented at: Conference on Retroviruses and Opportunistic Infections; 2015; Seattle, Washington.

  18. 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 

  19. 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  PubMed Central  Google Scholar 

  20. Escudero DJ, Lurie MN, Kerr T, Howe CJ, Marshall BDL. HIV pre-exposure prophylaxis for people who inject drugs: a review of current results and an agenda for future research. J Int AIDS Soc. 2014;17(1):18899.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Eisingerich AB, Wheelock A, Gomez GB, Garnett GP, Dybul MR, Piot PK. Attitudes and acceptance of oral and parenteral HIV preexposure prophylaxis among potential user groups: a multinational study. PLoS ONE. 2012;7(1):e28238.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Kuo I, Olsen H, Patrick R, et al. Willingness to use HIV pre-exposure prophylaxis among community-recruited, older people who inject drugs in Washington, DC. Drug Alcohol Depend. 2016;164:8–13.

    Article  PubMed  Google Scholar 

  23. Walters SM, Reilly KH, Neaigus A, Braunstein S. Awareness of pre-exposure prophylaxis (PrEP) among women who inject drugs in NYC: the importance of networks and syringe exchange programs for HIV prevention. Harm Reduct J. 2017;14(1):40.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Escudero DJ, Kerr T, Wood E, et al. Acceptability of HIV pre-exposure prophylaxis (PrEP) among people who inject drugs (PWID) in a Canadian setting. AIDS Behav. 2015;19(5):752–7.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Stein M, Thurmond P, Bailey G. Willingness to use HIV pre-exposure prophylaxis among opiate users. AIDS Behav. 2014;18(9):1694–700.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Roth AM, Goldshear JL, Martinez-Donate AP, Welles S, Chavis M, Van Der Pol B. Reducing missed opportunities: pairing sexually transmitted infection screening with syringe exchange services. Sex Transm Dis. 2016;43(11):706–8.

    Article  PubMed  Google Scholar 

  27. Shrestha R, Karki P, Altice FL, et al. Correlates of willingness to initiate pre-exposure prophylaxis and anticipation of practicing safer drug- and sex-related behaviors among high-risk drug users on methadone treatment. Drug Alcohol Depend. 2017;173:107–16.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Walters SM, Rivera AV, Starbuck L, et al. Differences in awareness of pre-exposure prophylaxis and post-exposure prophylaxis among groups at-risk for HIV in New York State: New York City and Long Island, NY, 2011–2013. J Acquir Immune Defic Syndr. 2017;75:S383–91.

    Article  PubMed  Google Scholar 

  29. Kelley CF, Kahle E, Siegler A, et al. Applying a PrEP continuum of care for men who have sex with men in Atlanta. Georgia. Clin Infect Dis. 2015;61(10):1590–7.

    Article  PubMed  Google Scholar 

  30. Behavioral Surveillance Team NCHSTP/DHAP-SE/BCSB. Model Surveillance Protocol, Injecting Drug Users (NHBS-IDU3) Heterosexuals at Increased Risk of HIV (NHBS-HET3). National HIV Behavioral Surveillance System Round 3; 2011.

  31. Gallagher KM, Sullivan PS, Lansky A, Onorato IM. Behavioral surveillance among people at risk for HIV infection in the US: the National HIV Behavioral Surveillance System. Public Health Rep. 2007;122:32–8.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Lansky A, Abdul-Quader AS, Cribbin M, et al. Developing an HIV behavioral surveillance system for injecting drug users: the National HIV Behavioral Surveillance System. Public Health Rep. 2007;122:48–55.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Heimer R, Abdala N. Viability of HIV-1 in syringes: implications for interventions among injection drug users. AIDS Read. 2000;10(7):410–7.

    CAS  PubMed  Google Scholar 

  34. aidsmap. Why is injecting drug use a risk for HIV transmission? NAM Publications, October 1, 2011. http://www.aidsmap.com/Why-is-injecting-drug-use-a-risk-for-HIV-transmission/page/1324128/. Accessed Jan 31 2018.

  35. Murphy S, Kelley MS, Lune H. The health benefits of secondary syringe exchange. J Drug Issues. 2004;34(2):245–68.

    Article  Google Scholar 

  36. Valente TW, Foreman RK, Junge B, Vlahov D. Needle-exchange participation, effectiveness, and policy: syringe relay, gender, and the paradox of public health. J Urban Health. 2001;78(2):340–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Latkin CA, Sherman S, Knowlton A. HIV prevention among drug users: outcome of a network-oriented peer outreach intervention. Health Psychol. 2003;22(4):332–9.

    Article  PubMed  Google Scholar 

  38. Latkin CA. Outreach in natural settings: the use of peer leaders for HIV prevention among injecting drug users’ networks. Public Health Rep. 1998;113(Suppl 1):151–9.

    PubMed  PubMed Central  Google Scholar 

  39. Garfein RS, Golub ET, Greenberg AE, et al. A peer-education intervention to reduce injection risk behaviors for HIV and hepatitis C virus infection in young injection drug users. AIDS. 2007;21(14):1923–32.

    Article  PubMed  Google Scholar 

  40. Latkin CA, Donnell D, Metzger D, et al. The efficacy of a network intervention to reduce HIV risk behaviors among drug users and risk partners in Chiang Mai, Thailand and Philadelphia, USA. Soc Sci Med. 2009;68(4):740–8.

    Article  PubMed  Google Scholar 

  41. Chan PA, Glynn TR, Oldenburg CE, et al. Implementation of preexposure prophylaxis for human immunodeficiency virus prevention among men who have sex with men at a New England sexually transmitted diseases clinic. Sex Transm Dis. 2016;43(11):717–23.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Petroll AE, Walsh JL, Owczarzak JL, et al. PrEP awareness, familiarity, comfort, and prescribing experience among US primary care providers and HIV specialists. AIDS Behav. 2017;21(5):1256–67.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Paquette CE, Syvertsen JL, Pollini RA. Stigma at every turn: health services experiences among people who inject drugs. Int J Drug Policy. 2018;57:104–10.

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

Supported by Grant No. 5 U1BPS003253 and funded by the Centers for Disease Control and Prevention.

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Authors and Affiliations

  1. Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, 3215 Market Street, Room 454, Philadelphia, PA, 19104, USA

    Alexis Roth & Brogan Piecara

  2. Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA

    Nguyen Tran & Seth Welles

  3. Philadelphia Department of Public Health, AIDS Activities Coordinating Office, Philadelphia, PA, USA

    Jennifer Shinefeld & Kathleen Brady

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  1. Alexis Roth
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Correspondence to Alexis Roth.

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Ethical Approval

All procedures involving human participants were reviewed and approved by the City of Philadelphia Institutional Review Board. This study does not contain animals.

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Informed consent was obtained from all individual participants included in the study.

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Roth, A., Tran, N., Piecara, B. et al. Factors Associated with Awareness of Pre-exposure Prophylaxis for HIV Among Persons Who Inject Drugs in Philadelphia: National HIV Behavioral Surveillance, 2015. AIDS Behav 23, 1833–1840 (2019). https://doi.org/10.1007/s10461-018-2293-0

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  • DOI: https://doi.org/10.1007/s10461-018-2293-0

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