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Rates of Pre-exposure Prophylaxis Use and Discontinuation Among a Large U.S. National Sample of Sexual Minority Men and Adolescents

  • Special Section: Social And Behavioral Science With Gay And Bisexual Men In The Era Of Biomedical Prevention
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Pre-exposure prophylaxis (PrEP) is highly effective in the prevention of HIV acquisition and was recently approved for those under 18 years of age. The primary goal of the present study was to understand the prevalence of and factors associated with PrEP use among a large sample of young and adult sexual minority men (Y/SMM). Participants came from a larger national sample of SMM. Data collected included demographics, substance use, PrEP use, and sexual risk. Participants were recruited via sexual networking/dating applications and resided in the U.S. including Puerto Rico, were at least 13 years old, self-reported being HIV-negative, and identified as male. The sample was divided into two groups: YSMM (13–24 years of age) and adult SMM (25 years of age and up). Multinomial logistic regressions examining associations with never, current, and former PrEP use were run with all variables of interest simultaneously entered into the models. Age was positively associated with both former and current PrEP use among YSMM. Additionally, YSMM who identified as gay (vs. bisexual), lived in the Northeast, Midwest, and West (vs. South), had their own health insurance (vs. those on their parent’s), had recently been diagnosed with an STI, and had recently used a drug all had higher odds of being a current PrEP user compared to those that had never used PrEP. Among adult SMM, those who were older did not have higher odds of current PrEP use compared to those that had never used PrEP. Those who identified as queer (vs. gay), single, had their own or were on their partner’s insurance (vs. parent’s), recent condomless anal sex, recent STI diagnosis, recent drug use, and recent substance use all had higher odds of being a current PrEP user compared to those that had never used PrEP. Research is needed to address the disparities in PrEP uptake among YSMM. Interventions for PrEP access among those on their parents’ insurance may also be necessary.

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The UNITE study was funded by a research grant from the National Institute of Allergy and Infectious Diseases and National Institute of Child Health and Human Development (UG3-AI133674: H. Jonathon Rendina, PI). Thomas H.F. Whitfield was supported by a Ruth L. Kirschstein National Research Service Award (NRSA) Individual Predoctoral Fellowship (Parent F31) (F31 MH116874-02). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors would like to acknowledge the contributions of the other members of the UNITE Study Team (Devin English, Steven A. John, Ali Talan, Stephen S. Jones, Juan Castiblanco, and Ruben Jimenez), our collaborators and consultants on the project (Brian Mustanski, Carlos Rodriguez-Diaz, Eli Rosenberg, and Mark Pandori) and all of the amazing staff from the Center for HIV/AIDS Educational Studies and Training. Finally, we thank all of our participants in the UNITE study.

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Correspondence to H. Jonathon Rendina.

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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.

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Whitfield, T.H.F., Parsons, J.T. & Rendina, H.J. Rates of Pre-exposure Prophylaxis Use and Discontinuation Among a Large U.S. National Sample of Sexual Minority Men and Adolescents. Arch Sex Behav 49, 103–112 (2020).

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