PrEP Awareness, Uptake, Barriers, and Correlates Among Adolescents Assigned Male at Birth Who Have Sex with Males in the U.S.

Macapagal, Kathryn; Kraus, Ashley; Korpak, Aaron K.; Jozsa, Kyle; Moskowitz, David A.

doi:10.1007/s10508-019-1429-2

Special Section: Social and Behavioral Science with Gay and Bisexual men in the Era of Biomedical Prevention
Published: 10 October 2019

PrEP Awareness, Uptake, Barriers, and Correlates Among Adolescents Assigned Male at Birth Who Have Sex with Males in the U.S.

Kathryn Macapagal ORCID: orcid.org/0000-0002-1208-6097^1,2,3,
Ashley Kraus^1,2,
Aaron K. Korpak^1,2,
Kyle Jozsa^1,2,3 &
David A. Moskowitz^1,2

Archives of Sexual Behavior volume 49, pages 113–124 (2020)Cite this article

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Abstract

In May 2018, the US Food and Drug Administration approved daily oral pre-exposure prophylaxis (PrEP) for adolescents under age 18. Although this is an important step toward HIV prevention for adolescents assigned male at birth who have sex with males (AMSM), limited research exists to gauge their awareness of PrEP as a prevention option. Additionally, the attitudes and perceived barriers regarding PrEP among this population have not been well studied. We conducted an online survey from February to April 2018, in which 219 AMSM age 15–17 read a description of PrEP, and then answered questions about PrEP awareness, perceived barriers, and demographic and behavioral correlates. A slight majority (54.8%) had heard of PrEP before, and 56.1% did not know how they would access PrEP. Of those who had heard of PrEP, 2.5% had ever used it. Most had first learned about PrEP online, through media or geosocial networking (GSN) applications to meet male partners. Those who had heard of PrEP were more likely to be older, to have used GSN applications, and to have greater HIV knowledge. Not knowing how to access PrEP was predicted by having had more partners, lower HIV knowledge, and never having talked to a provider about PrEP. Believing that one could not afford PrEP was predicted by greater perceived risk of HIV. Findings suggest moderate awareness of PrEP among AMSM, that youth at greater risk of HIV may perceive greater barriers, and that online spaces can play a significant role in increasing PrEP knowledge and reducing implementation barriers.

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Acknowledgments

This research was supported by a grant from the Sexualities Project at Northwestern to Kathryn Macapagal.

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Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Avenue, Suite 1400, Chicago, IL, 60611, USA
Kathryn Macapagal, Ashley Kraus, Aaron K. Korpak, Kyle Jozsa & David A. Moskowitz
Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
Kathryn Macapagal, Ashley Kraus, Aaron K. Korpak, Kyle Jozsa & David A. Moskowitz
Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
Kathryn Macapagal & Kyle Jozsa

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Kathryn Macapagal
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Ashley Kraus
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Aaron K. Korpak
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Kyle Jozsa
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David A. Moskowitz
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Correspondence to Kathryn Macapagal.

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Macapagal, K., Kraus, A., Korpak, A.K. et al. PrEP Awareness, Uptake, Barriers, and Correlates Among Adolescents Assigned Male at Birth Who Have Sex with Males in the U.S.. Arch Sex Behav 49, 113–124 (2020). https://doi.org/10.1007/s10508-019-1429-2

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Received: 30 August 2018
Revised: 20 February 2019
Accepted: 21 February 2019
Published: 10 October 2019
Issue Date: January 2020
DOI: https://doi.org/10.1007/s10508-019-1429-2

Keywords

Adolescent sexual behavior
Sexual and gender minorities
Men who have sex with men
Pre-exposure prophylaxis
HIV/AIDS
Sexual orientation