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Awareness and Acceptability of Pre-exposure HIV Prophylaxis Among Men Who have Sex with Men in Baltimore

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Abstract

This paper assessed characteristics associated with awareness of and willingness to take pre-exposure prophylaxis (PrEP) among Baltimore men who have sex with men (MSM). We used data from BESURE-MSM3, a venue-based cross-sectional HIV surveillance study conducted among MSM in 2011. Multivariate regression was used to identify characteristics associated with PrEP knowledge and acceptability among 399 participants. Eleven percent had heard of PrEP, 48% would be willing to use PrEP, and none had previously used it. In multivariable analysis, black race and perceived discrimination against those with HIV were significantly associated with decreased awareness, and those who perceived higher HIV discrimination reported higher acceptability of PrEP. Our findings indicate a need for further education about the potential utility of PrEP in addition to other prevention methods among MSM. HIV prevention efforts should address the link between discrimination and potential PrEP use, especially among men of color.

Resumen

Evaluamos las características asociadas con el conocimiento y la voluntad de hombres que tienen sexo con hombres (HSH) en Baltimore de tomar profilaxis de pre-exposición al VIH (PrEP, por sus siglas en inglés). Utilizamos datos de BESURE-MSM3, un estudio transversal de vigilancia del VIH realizado entre HSH en el año 2011. Se utilizó el método de regresión multivariante para identificar las características asociadas con el conocimiento y aceptabilidad de PrEP entre 399 participantes. El once por ciento habían previamente escuchado de PrEP, el 48% serian dispuestos a utilizar PrEP, y ningún participante había previamente utilizado PrEP. En el análisis multivariante, ser de la raza negra y la percepción de discriminación contra las personas que viven con el VIH fueron asociadas significativamente con la disminución del conocimiento sobre PrEP, aunque los que indicaron más alta percepción de discriminación asociada con el VIH reportaron más alta aceptabilidad de PrEP. Nuestros resultados indican la necesidad de una mayor educación sobre la utilidad potencial de PrEP, además de otros métodos de prevención del VIH entre HSH. Los esfuerzos de prevención del VIH necesitan abordar el vínculo entre la discriminación y el uso potencial de PrEP, especialmente entre HSH negros.

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Acknowledgements

The authors wish to acknowledge and thank the many participants in NHBS Baltimore (BESURE) as well as the many dedicated BESURE team members for their invaluable contributions over time.

Funding

This study was funded by contracts to the Johns Hopkins University from the Maryland Department of Health and Mental Hygiene and by cooperative agreements between the Maryland Department of Health and Mental Hygiene and the Centers for Disease Control and Prevention (CDC).

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Authors and Affiliations

  1. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA

    Susan A. Fallon

  2. Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA

    Ju Nyeong Park, Christine Powell Ogbue & Danielle German

  3. Maryland Department of Health and Mental Hygiene, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Colin Flynn

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Correspondence to Danielle German.

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Conflict of interest

Susan Fallon and Dr. Colin Flynn do not receive any external funding and have no conflicts of interest to report. Dr. Danielle German receives funding from Johns Hopkins CFAR, the National Institutes of Health, PCORI, and from CDC via the Maryland Department of Health and Mental Hygiene to implement National HIV Behavioral Surveillance for this study. The CFAR, NIH, and PCORI played no role in the current study. The CDC provided the study protocol and technical support for project implementation. CDC played no role in analysis, interpretation of data, report writing, or the decision to submit the report for publication.

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

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Fallon, S.A., Park, J.N., Ogbue, C.P. et al. Awareness and Acceptability of Pre-exposure HIV Prophylaxis Among Men Who have Sex with Men in Baltimore. AIDS Behav 21, 1268–1277 (2017). https://doi.org/10.1007/s10461-016-1619-z

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