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Preferences for Injectable PrEP Among Young U.S. Cisgender Men and Transgender Women and Men Who Have Sex with Men

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Abstract

Young men who have sex with men account for approximately 20% of incident HIV infections in the U.S. Antiretroviral pre-exposure prophylaxis (PrEP) administered as a daily pill has been shown to decrease HIV acquisition in at-risk individuals. New modalities for PrEP are being developed and tested, including injectable PrEP; however, acceptability of these emerging modalities has not yet been examined in youth. We conducted six focus groups with 36 young men and transgender men and women who have sex with men in Boston, Chicago, and Los Angeles in 2016 to assess interest in and preference for different PrEP modalities. Youth were purposively recruited based on diversity of age, race/ethnicity, and prior PrEP experience. Data were coded using content coding based on key domains of the interview guide, in particular around the central themes of interest in and barriers and facilitators to injectable PrEP use. Participants were knowledgeable about oral PrEP but suggested barriers to broader uptake, including stigma, marginalization, and access to information. While participants were split on preference for injectable versus oral PrEP, they agreed quarterly injections may be more manageable and better for those who have adherence difficulties and for those who engage in sex more frequently. Concerns specific to injectable PrEP included: severity/duration of side effects, pain, level of protection prior to next injection, distrust of medical system and injections, and cost. Understanding barriers to and preferences for diverse prevention modalities will allow for more HIV prevention options, improved products, and better interventions, thus allowing individuals to make informed HIV prevention choices.

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Acknowledgements

This study was supported by Viiv Healthcare, Inc. Additional support for Dr. Mayer’s role was provided by the Harvard University Center for AIDS Research (CFAR), an NIH Funded Program (P30 AI060354), which is supported by the following NIH Co-Funding and Participating Institutes and Centers: NIAID, NCI, NICHD, NHLBI, NIDA, NIMH, NIA, NIDDK, NIGMS, NIMHD, FIC, and OAR. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, 02912, USA

    Katie B. Biello & Matthew J. Mimiaga

  2. Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA

    Katie B. Biello & Matthew J. Mimiaga

  3. The Fenway Institute, Fenway Health, Boston, MA, USA

    Katie B. Biello, Morgan T. Drucker, Matthew J. Mimiaga, Elliot Marrow, Julia Coffey-Esquivel & Kenneth H. Mayer

  4. Center for Health Equity Research, Brown University, Providence, RI, USA

    Katie B. Biello & Matthew J. Mimiaga

  5. Department of Psychiatry, Stroger Hospital of Cook County, Chicago, IL, USA

    Sybil Hosek & Jennifer Brothers

  6. Division of Adolescent Medicine, Children’s Hospital Los Angeles, Los Angeles, CA, USA

    Marvin Belzer

  7. Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Kenneth H. Mayer

  8. Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA

    Kenneth H. Mayer

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  1. Katie B. Biello
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  2. Sybil Hosek
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  3. Morgan T. Drucker
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  4. Marvin Belzer
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  5. Matthew J. Mimiaga
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  6. Elliot Marrow
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  7. Julia Coffey-Esquivel
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  8. Jennifer Brothers
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  9. Kenneth H. Mayer
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Correspondence to Katie B. Biello.

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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. This article does not contain any studies with animals performed by any of the authors.

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

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Biello, K.B., Hosek, S., Drucker, M.T. et al. Preferences for Injectable PrEP Among Young U.S. Cisgender Men and Transgender Women and Men Who Have Sex with Men. Arch Sex Behav 47, 2101–2107 (2018). https://doi.org/10.1007/s10508-017-1049-7

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  • DOI: https://doi.org/10.1007/s10508-017-1049-7

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