1271. Pre-Exposure Prophylaxis (PrEP) Awareness and Uptake Between Men Who Have Sex with Men and Men Who Have Sex with Men and Women

Abstract Background Men who have sex with men are disproportionately impacted by HIV in the United States and may benefit most from pre-exposure prophylaxis (PrEP). However, differences may exist between men who only have sex with men (MSM) and men who have sex with both men and women (MSMW). MSMW may experience more barriers to accessing PrEP and may act as a potential bridge population for transmitting HIV to female sex partners. Differences in PrEP awareness and use between MSM and MSMW are unknown. Methods We evaluated all MSM and MSMW presenting to the Rhode Island Sexually Transmitted Diseases (STD) clinic and PrEP clinic from 2013–2017. Demographics and behavioral information were reviewed. Bivariate analyses were performed to present distributions of demographic and behavioral characteristics by sexual behavior. Logistic regression was conducted to explore associations between PrEP awareness/use and sexual behavior. Confounding variables were identified using the directed acyclic graphs (DAGs) and a priori. Results Of 1,795 male individuals, 84% (1,504) were MSM, and 16% (291) were MSMW. The median age of our study population was 29 (interquartile range [IQR]: 23–42). When compared with MSM, MSMW were more likely to be non-White (33% vs. 28%), uninsured (54% vs.46%), self-report more sexual partners in the past 12 months (median 6 [IQR: 3–9]: vs. 4 [IQR:2–10]), use intranasal cocaine (21% vs. 12%), and engage in selling (6% vs. 2%) or buying sex (12% vs. 4%, all P < 0.05). MSMW were also less likely to have a previous HIV test (77% vs. 89%) compared with MSM. MSMW were 59% (adjusted odds ratio [aOR]: 041, 95% confidence interval [CI]: 0.31–0.55) less likely to be aware of PrEP and 17% (aOR: 0.83, 95% CI: 0.41–1.66) less likely to report ever using PrEP after adjusting for age, race/ethnicity, and self-reported HIV risk. Conclusion Despite engaging in higher risk behaviors, MSMW were significantly less likely to be aware of or use PrEP compared with MSM. Future PrEP interventions are needed to target this potentially high-risk bridge population. Disclosures All authors: No reported disclosures.

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Prevalence and Correlates of PrEP Awareness and Use Among Black Men Who Have Sex with Men and Women (MSMW) in the United States

AIDS and Behavior ◽

10.1007/s10461-019-02446-3 ◽

2019 ◽

Vol 23 (10) ◽

pp. 2694-2705 ◽

Cited By ~ 5

Author(s):

M. Reuel Friedman ◽

Jordan M. Sang ◽

Leigh A. Bukowski ◽

Cristian J. Chandler ◽

James E. Egan ◽

...

Keyword(s):

United States ◽

Black Men ◽

The United States ◽

Men And Women ◽

Sex With Men ◽

Prep Awareness

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Characterizing Awareness of Pre-Exposure Prophylaxis for HIV Prevention in Manila and Cebu, Philippines: Web-Based Survey of Filipino Cisgender Men Who Have Sex With Men (Preprint)

10.2196/preprints.24126 ◽

2020 ◽

Author(s):

Arjee Restar ◽

Anthony Surace ◽

Alexander Adia ◽

William Goedel ◽

Adedotun Ogunbajo ◽

...

Keyword(s):

Public Health ◽

Hiv Prevention ◽

Multivariable Analysis ◽

College Education ◽

The Philippines ◽

Web Based ◽

Hiv Test ◽

Sex With Men ◽

Prep Awareness ◽

Exposure Prophylaxis

BACKGROUND The Philippines is experiencing an HIV crisis and is considering implementing pre-exposure prophylaxis (PrEP) as a national public health strategy for HIV prevention for cisgender men who have sex with men (cis-MSM). However, critical information on the awareness of PrEP among cis-MSM is needed to roll out this public health initiative. OBJECTIVE This study aims to assess PrEP awareness and related correlates (ie, sociodemographic variables, social factors, and health care access and use) among Filipino cis-MSM. METHODS We conducted a web-based survey with Filipino cis-MSM (n=179) residing in the cities of Manila and Cebu, Philippines. Multivariable analysis procedures were performed to examine the factors associated with PrEP awareness. RESULTS Our sample demonstrated high awareness (134/179, 74.9%) and interest (159/179, 88.8%) in taking PrEP. The adjusted model showed that greater odds of PrEP awareness were associated with having a college education or higher versus a high school education or lower (adjusted odds ratio [aOR] 7.30, 95% CI 1.01-52.47), earning between PHP 10,000 (US $198.6) and PHP 20,000 (US $397.2) versus <PHP 10,000 (US $198.60; aOR 9.32, 95% CI 1.41-6.22), having had a prior HIV test (aOR 6.06, 95% CI 1.20-13.55), having high HIV knowledge (aOR 3.50, 95% CI 1.11-10.98), and having friends who discussed PrEP (aOR 11.17, 95% CI 2.73-14.5). CONCLUSIONS Our findings demonstrate that Filipino cis-MSM are aware of and interested in taking PrEP, but there is currently an unmet need for such biomedical HIV prevention technologies among this population. Incorporating PrEP education into routine HIV screening and leveraging cis-MSM social networks may be useful in optimizing potential PrEP implementation in the Philippines.

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Statewide Evaluation of New HIV Diagnoses in Rhode Island: Implications for Prevention

Public Health Reports ◽

10.1177/0033354918777255 ◽

2018 ◽

Vol 133 (4) ◽

pp. 489-496

Author(s):

Philip A. Chan ◽

Madeline C. Montgomery ◽

Jennifer Rose ◽

Alec Tributino ◽

Christina Crowley ◽

...

Keyword(s):

United States ◽

Rhode Island ◽

Latent Class ◽

Hiv Transmission ◽

The United States ◽

Newly Diagnosed ◽

Foreign Born ◽

Class 1 ◽

Sex With Men ◽

Exposure Prophylaxis

Objectives: Patterns of HIV transmission vary widely across demographic groups. Identifying and engaging these groups are necessary to prevent new infections and diagnose disease among people who are unaware of their infection. The objective of this study was to determine characteristics of newly diagnosed individuals across an entire state to determine patterns of HIV transmission. Methods: We evaluated data on people with new HIV diagnoses in Rhode Island from 2013 through 2015. We performed a latent class analysis (LCA) to identify underlying demographic and behavioral characteristics of people with newly diagnosed HIV. Results: Of 167 people with new HIV diagnoses interviewed in Rhode Island from 2013 through 2015, 132 (79%) were male, 84 (50%) were nonwhite, 112 (67%) were men who have sex with men (MSM), 112 (67%) were born in the United States, and 61 (37%) were born in Rhode Island. LCA revealed 2 major classes. Of the 98 people in class 1, 96% were male, 85% were MSM, 80% were white, 94% were born in the United States, and 80% believed they acquired HIV in Rhode Island. Class 2 was 63% male and 69% Hispanic/Latino; 29% were born in the United States, and 61% believed they acquired HIV in Rhode Island. Conclusions: Most new HIV diagnoses in Rhode Island were among MSM born in the United States, and a substantial number were likely infected in-state. People with newly diagnosed HIV who were foreign-born, including Hispanic/Latino and heterosexual groups, were less likely to have acquired HIV in Rhode Island than were MSM. HIV prevention approaches, including pre-exposure prophylaxis, should be adapted to the needs of specific groups. Rhode Island offers lessons for other states focused on eliminating HIV transmission.

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Reporting pre-exposure prophylaxis use in Craigslist personal advertisements among men seeking sex with men in the United States

Sexual Health ◽

10.1071/sh16221 ◽

2017 ◽

Vol 14 (4) ◽

pp. 397 ◽

Cited By ~ 1

Author(s):

Brandon J. Hill ◽

Trevor Bak ◽

Alicia VandeVusse ◽

Kris Rosentel

Keyword(s):

United States ◽

Healthcare Providers ◽

The United States ◽

Personal Ads ◽

Personal Advertisements ◽

Bareback Sex ◽

Sex With Men ◽

Prep Awareness ◽

Exposure Prophylaxis ◽

Sexual Risk Behaviours

This study describes the self-reported use of pre-exposure prophylaxis (PrEP) in the personal advertisements of men seeking sex with men in the United States on the online classified advertisement site, Craigslist. Overall self-reported PrEP use was low (0.20%; 95% confidence interval (CI) = 0.18–0.22). However, PrEP use in personal ads was described in conjunction with seeking sexual risk behaviours including ‘bareback’ sex (22.7%; 95% CI = 17.7–27.7%) and sex with substance use (26.8%; 95% CI = 21.5–32.1%). Only 4.0% of personal ads sought safe sex (3.3%; 95% CI = 1.2–5.4%) or required condoms (0.7%; 95% CI = –0.3–1.7%). Our findings underscore the need for increased public PrEP awareness, particularly among men seeking sex with men, as well as the importance of healthcare providers emphasising sexually transmissible infection prevention behaviours (i.e. condom use) used in conjunction with PrEP.

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A Crowdsourcing Open Contest to Design Pre-Exposure Prophylaxis Promotion Messages: Protocol for an Exploratory Mixed Methods Study

JMIR Research Protocols ◽

10.2196/15590 ◽

2020 ◽

Vol 9 (1) ◽

pp. e15590

Author(s):

Jordan J White ◽

Allison Mathews ◽

Marcus P Henry ◽

Meghan B Moran ◽

Kathleen R Page ◽

...

Keyword(s):

Mixed Methods ◽

Community Engagement ◽

The United States ◽

Medical Mistrust ◽

Community Assets ◽

Community Needs ◽

Group 2 ◽

Sex With Men ◽

Prep Awareness ◽

Exposure Prophylaxis

Background In the United States, black men who have sex with men (BMSM) are disproportionately affected by HIV. Pre-exposure prophylaxis (PrEP) can reduce HIV incidence. However, real-world implementation of PrEP outside of clinical trials has identified racial disparities in PrEP awareness, uptake, and adherence. In the context of a long history of medical mistrust and power imbalances between scientists and community members, strategies to increase uptake of PrEP among BMSM should consider ways to ensure messages address the needs and priorities of the community. Crowdsourcing contests shift traditional individual tasks to a large group and may enhance community engagement. Objective This paper describes the research protocol of a contest approach to soliciting PrEP promotion messages among BMSM in Baltimore. Methods Open-contest implementation and evaluation will proceed as follows: (1) organize a community steering group; (2) develop platforms to solicit crowd input; (3) engage the community to contribute ideas through a Web-based forum and in-person events; (4) evaluate contest entries using both community panel judge assessment and crowd voting; (5) utilize mixed methods to evaluate feasibility, acceptability, and community engagement; and (6) disseminate contest results. Results This study was funded by the National Institutes of Health (National Institute of Mental Health: R34MH116725) in May 2018 and was approved by the institutional review board in April 2018. The open contest started in February 2019, and data analyses for the mixed method evaluation are expected to complete in December 2019. Conclusions The contest will potentially bring new ideas in developing more impactful and locally defined PrEP promotion campaigns. We will determine whether an open-contest approach is acceptable among BMSM in Baltimore. If successful, this study can inform future projects using a similar approach on how to identify and implement programs and policies that are more responsive to community needs and that build up community assets. International Registered Report Identifier (IRRID) DERR1-10.2196/15590

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Characterizing Awareness of Pre-Exposure Prophylaxis for HIV Prevention in Manila and Cebu, Philippines: Web-Based Survey of Filipino Cisgender Men Who Have Sex With Men

Journal of Medical Internet Research ◽

10.2196/24126 ◽

2022 ◽

Vol 24 (1) ◽

pp. e24126

Author(s):

Arjee Restar ◽

Anthony Surace ◽

Alexander Adia ◽

William Goedel ◽

Adedotun Ogunbajo ◽

...

Keyword(s):

Public Health ◽

Hiv Prevention ◽

Multivariable Analysis ◽

College Education ◽

The Philippines ◽

Web Based ◽

Hiv Test ◽

Sex With Men ◽

Prep Awareness ◽

Exposure Prophylaxis

Background The Philippines is experiencing an HIV crisis and is considering implementing pre-exposure prophylaxis (PrEP) as a national public health strategy for HIV prevention for cisgender men who have sex with men (cis-MSM). However, critical information on the awareness of PrEP among cis-MSM is needed to roll out this public health initiative. Objective This study aims to assess PrEP awareness and related correlates (ie, sociodemographic variables, social factors, and health care access and use) among Filipino cis-MSM. Methods We conducted a web-based survey with Filipino cis-MSM (n=179) residing in the cities of Manila and Cebu, Philippines. Multivariable analysis procedures were performed to examine the factors associated with PrEP awareness. Results Our sample demonstrated high awareness (134/179, 74.9%) and interest (159/179, 88.8%) in taking PrEP. The adjusted model showed that greater odds of PrEP awareness were associated with having a college education or higher versus a high school education or lower (adjusted odds ratio [aOR] 7.30, 95% CI 1.01-52.47), earning between PHP 10,000 (US $198.6) and PHP 20,000 (US $397.2) versus <PHP 10,000 (US $198.60; aOR 9.32, 95% CI 1.41-6.22), having had a prior HIV test (aOR 6.06, 95% CI 1.20-13.55), having high HIV knowledge (aOR 3.50, 95% CI 1.11-10.98), and having friends who discussed PrEP (aOR 11.17, 95% CI 2.73-14.5). Conclusions Our findings demonstrate that Filipino cis-MSM are aware of and interested in taking PrEP, but there is currently an unmet need for such biomedical HIV prevention technologies among this population. Incorporating PrEP education into routine HIV screening and leveraging cis-MSM social networks may be useful in optimizing potential PrEP implementation in the Philippines.

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A Crowdsourcing Open Contest to Design Pre-Exposure Prophylaxis Promotion Messages: Protocol for an Exploratory Mixed Methods Study (Preprint)

10.2196/preprints.15590 ◽

2019 ◽

Author(s):

Jordan J White ◽

Allison Mathews ◽

Marcus P Henry ◽

Meghan B Moran ◽

Kathleen R Page ◽

...

Keyword(s):

Mixed Methods ◽

Community Engagement ◽

The United States ◽

Medical Mistrust ◽

Community Assets ◽

Community Needs ◽

Group 2 ◽

Sex With Men ◽

Prep Awareness ◽

Exposure Prophylaxis

BACKGROUND In the United States, black men who have sex with men (BMSM) are disproportionately affected by HIV. Pre-exposure prophylaxis (PrEP) can reduce HIV incidence. However, real-world implementation of PrEP outside of clinical trials has identified racial disparities in PrEP awareness, uptake, and adherence. In the context of a long history of medical mistrust and power imbalances between scientists and community members, strategies to increase uptake of PrEP among BMSM should consider ways to ensure messages address the needs and priorities of the community. Crowdsourcing contests shift traditional individual tasks to a large group and may enhance community engagement. OBJECTIVE This paper describes the research protocol of a contest approach to soliciting PrEP promotion messages among BMSM in Baltimore. METHODS Open-contest implementation and evaluation will proceed as follows: (1) organize a community steering group; (2) develop platforms to solicit crowd input; (3) engage the community to contribute ideas through a Web-based forum and in-person events; (4) evaluate contest entries using both community panel judge assessment and crowd voting; (5) utilize mixed methods to evaluate feasibility, acceptability, and community engagement; and (6) disseminate contest results. RESULTS This study was funded by the National Institutes of Health (National Institute of Mental Health: R34MH116725) in May 2018 and was approved by the institutional review board in April 2018. The open contest started in February 2019, and data analyses for the mixed method evaluation are expected to complete in December 2019. CONCLUSIONS The contest will potentially bring new ideas in developing more impactful and locally defined PrEP promotion campaigns. We will determine whether an open-contest approach is acceptable among BMSM in Baltimore. If successful, this study can inform future projects using a similar approach on how to identify and implement programs and policies that are more responsive to community needs and that build up community assets. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/15590

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Knowledge, Attitudes and Practices Regarding Pre-Exposure Prophylaxis (PrEP) in a Sample of Italian Men Who Have SEX with MEN (MSM)

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094772 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4772

Author(s):

Gianluca Voglino ◽

Maria Rosaria Gualano ◽

Stefano Rousset ◽

Pietro Forghieri ◽

Isabella Fraire ◽

...

Keyword(s):

Online Survey ◽

Immune Deficiency Syndrome ◽

Deficiency Syndrome ◽

Attitudes And Practices ◽

Immunodeficiency Virus ◽

Sex With Men ◽

Prep Awareness ◽

Exposure Prophylaxis ◽

The Cost ◽

Knowledge Attitudes And Practices

Background: Pre-exposure prophylaxis (PrEP) is suitable for high human immunodeficiency virus (HIV)-infection risk people, foremost among whom are males who have sex with other males (MSM). This study evaluated knowledge, attitudes and practices regarding PrEP in a sample of Italian MSM, in order to hypothesize strategies to implement PrEP awareness and use. No previous study has assessed this issue; Methods: An online survey was given to an opportunistic sample of Italian MSM. The questionnaire investigated sexual behaviour and habits, HIV/acquired immune deficiency syndrome (AIDS) knowledge and PrEP awareness, attitudes and practices. Univariable and multivariable logistic regressions were conducted to identify factors associated with PrEP knowledge; Results: A total of 196 MSM participated in this survey. Overall data showed that 87.2% of participants knew what PrEP is, but only 7.5% have ever used it. The main reason for not using PrEP was the cost of the therapy (26.9%). The principal source of PrEP information was the Internet (68.4%). Being regularly tested for HIV was significantly associated with PrEP knowledge (adjusted odds ratio (AdjOR) = 3.16; confidence interval (CI) = 1.06–9.29); Conclusions: Knowledge regarding PrEP was well established, but PrEP use was not equally widespread. It is necessary to improve research on PrEP usage in order to PrEP access to be granted.

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