scholarly journals Sociocultural Influences on Attitudes Toward Pre-exposure Prophylaxis (PrEP), History of PrEP Use, and Future PrEP Use in HIV-Vulnerable Cisgender Men Who Have Sex With Men Across the United States

2020 ◽  
Vol 1 (2) ◽  
pp. 128-158
Author(s):  
Drew A. Westmoreland ◽  
Viraj V. Patel ◽  
Alexa B. D'Angelo ◽  
Denis Nash ◽  
Christian Grov
Keyword(s):  
Social Media ◽  
Hiv Transmission ◽  
Social Influences ◽  
The United States ◽  
Social Connections ◽  
Sources Of Information ◽  
National Cohort ◽  
History Of ◽  
Sex With Men ◽  
Exposure Prophylaxis

Despite its proven effectiveness in reducing HIV transmission, pre-exposure prophylaxis (PrEP) use remains low. This study used data from a 2017–2018 U.S. national cohort to investigate social influences on PrEP experience and future PrEP use among cisgender men who have sex with men. We used descriptive statistics and multivariable logistic analyses to examine social influences (e.g., how participants heard about PrEP and number of persons they knew taking PrEP) associated with each previous PrEP use and intentions to use PrEP. Among participants who knew of PrEP, commonly reported ways of first hearing about PrEP were through social media (27.4%) and friends (26.8%). These were also cited top influences on participants' current attitudes toward PrEP (friends 23.5%, social media 22.1%). Multivariable logistic regression analyses found that knowing more people taking PrEP was associated with increased odds of previously using PrEP and intending to use PrEP. Friends and social media were common and influential sources of information regarding PrEP. Results suggest that tapping into these social connections may effectively disseminate public health messaging about PrEP and encourage use among key populations to reduce HIV burden.

scholarly journals Individual and Partner Characteristics Associated With Intentions to Use PrEP Among Partnered Men, Trans Men, and Trans Women in Sero-Concordant and -Discordant Relationships in the United States

2020 ◽  
Vol 32 (5) ◽  
pp. 367-377
Author(s):  
Drew A. Westmoreland ◽  
Alexa D'Angelo ◽  
Denis Nash ◽  
Christian Grov
Keyword(s):  
Hiv Transmission ◽  
The United States ◽  
Hiv Positive ◽  
Main Partner ◽  
Trans Men ◽  
Prevention Interventions ◽  
Partner Characteristics ◽  
National Cohort ◽  
Sex With Men ◽  
Exposure Prophylaxis

Despite proven effectiveness in reducing HIV transmission, pre-exposure prophylaxis (PrEP) use remains low among those who meet the recommended CDC guidance for PrEP use. Data are from a U.S. national cohort of men and trans persons who have sex with men (2017–2018). Logistic regression analyses were used to determine individual and partner factors associated with intentions to use PrEP among non-PrEP-using participants reporting a main partner (n = 1,671). Prior PrEP use among participants (14.2%) and their partners (7.7%) was low. Participants’ prior PrEP use and main partner's HIV-positive status were both positively associated with intentions to use PrEP. HIV prevention interventions incorporating main partners may be effective in increasing PrEP use.

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

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.

scholarly journals Pre-exposure prophylaxis uptake among users of non-occupational post-exposure prophylaxis: a longitudinal analysis of attendees at a large sexual health clinic in Montréal

2020 ◽  
Author(s):  
Yiqing Xia ◽  
R. Zoë Greenwald ◽  
M. Rachael Milwid ◽  
Claire Trottier ◽  
Michel Boissonnault ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Health Clinic ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
History Of ◽  
Sex With Men ◽  
Exposure Prophylaxis

AbstractBackgroundReducing HIV transmission using pre-exposure prophylaxis (PrEP) requires targeting individuals at high acquisition risk, such as men who have sex with men (MSM) with a history of non-occupational post-exposure prophylaxis (nPEP). This study aims to characterize longitudinal trends in PrEP uptake and its determinants among nPEP users in Montréal.MethodsEligible attendees at Clinique médicale l’Actuel were recruited prospectively starting in October 2000 (nPEP) and January 2013 (PrEP). Linking these cohorts, we characterized the PEP-to-PrEP cascade, examined the determinants of PrEP uptake after nPEP consultation using a Cox proportional-hazard model, and assessed whether PrEP persistence differed by nPEP history using Kaplan-Meier curves.ResultsAs of August 2019, 31% of 2,682 MSM nPEP cohort participants had two or more nPEP consultations. Subsequent PrEP consultations occurred among 36% of nPEP users, of which 17% sought nPEP again afterwards. Among 2,718 PrEP cohort participants, 46% reported previous nPEP use. Among nPEP users, those aged 25-49 years (Hazard Ratio (HR)=1.3, 95% confidence interval (CI): 1.1-1.7), with more nPEP episodes (HR=1.4, 95%CI: 1.3-1.5), reported chemsex (HR=1.3, 95%CI: 1.1-1.7), with a STI history (HR=1.5; 95%CI: 1.3-1.7), and who returned for their first nPEP follow-up visit (HR=3.4, 95%CI: 2.7-4.2) had higher rates of PrEP linkage. There was no difference in PrEP persistence between PEP-to-PrEP and PrEP only participants.ConclusionOver one-third of nPEP users were subsequently prescribed PrEP. However, the large proportion of men who repeatedly use nPEP calls for more efficient PrEP-linkage services and, among those that use PrEP, improved persistence should be encouraged.

scholarly journals Evolution of the syphilis epidemic among men who have sex with men

Sexual Health ◽  
2015 ◽  
Vol 12 (2) ◽  
pp. 96 ◽  
Author(s):  
Marc M. Solomon ◽  
Kenneth H. Mayer
Keyword(s):  
Hiv Transmission ◽  
Risk Behaviour ◽  
Syphilis Infection ◽  
Aids Epidemic ◽  
Multiple Partners ◽  
High Risk Behaviour ◽  
Significant Public Health ◽  
History Of ◽  
Sex With Men ◽  
Exposure Prophylaxis

Syphilis has existed for millenni, but its epidemiology was only recently linked to men who have sex with men (MSM) after the introduction of penicillin in the 1940s; the syphilis epidemic became concentrated within the MSM community in subsequent decades. The HIV/AIDS epidemic in the 1980s led to a surge of new syphilis cases and revealed the potentiation between HIV and syphilis, as evidenced by a shift in the natural history of neurosyphilis. In response, MSM revolutionised their sexual behaviour by implementing community-driven seroadaptive strategies to stem HIV transmission. The Centers for Disease Control in the US called for the elimination of syphilis in the late 1990s since the rates had fallen sharply but this effort was overtaken by a resurgence of global outbreaks among MSM in the 2000s, many of which were linked to methamphetamine use and sexual networking websites. Syphilis remains highly prevalent today, especially among MSM and individuals infected with HIV, and it continues to present a significant public health conundrum. Innovative syphilis prevention strategies are warranted. MSM engaging in high-risk behaviour such as condomless anal receptive intercourse, sex with multiple partners or recreational drug use should be routinely screened for syphilis infection; they should also be counselled about the limits of seroadaptive behaviours and HIV pre-exposure prophylaxis as they relate to syphilis transmission.

scholarly journals Implementation of a Rapid Entry Program Decreases Time to Viral Suppression Among Vulnerable Persons Living With HIV in the Southern United States

2018 ◽  
Vol 5 (6) ◽  
Author(s):  
Jonathan Colasanti ◽  
Jeri Sumitani ◽  
C Christina Mehta ◽  
Yiran Zhang ◽  
Minh Ly Nguyen ◽  
...  
Keyword(s):  
United States ◽  
Viral Suppression ◽  
Hiv Transmission ◽  
Positive Impact ◽  
Population Level ◽  
The United States ◽  
Clinic Visit ◽  
Art Initiation ◽  
Persons Living With Hiv ◽  
Sex With Men

Abstract Background Rapid entry programs (REPs) improve time to antiretroviral therapy (ART) initiation (TAI) and time to viral suppression (TVS). We assessed the feasibility and effectiveness of a REP in a large HIV clinic in Atlanta, Georgia, serving a predominately un- or underinsured population. Methods The Rapid Entry and ART in Clinic for HIV (REACH) program was implemented on May 16, 2016. We performed a retrospective cohort study with the main independent variable being period of enrollment: January 1, 2016, through May 15, 2016 (pre-REACH); May 16, 2016, through July 31, 2016 (post-REACH). Included individuals were HIV-infected and new to the clinic with detectable HIV-1 RNA. Six-month follow-up data were collected for each participant. Survival analyses were conducted for TVS. Logistic and linear regression analyses were used to evaluate secondary outcomes: attendance at first clinic visit, viral suppression, TAI, and time to first attended provider visit. Results There were 117 pre-REACH and 90 post-REACH individuals. Median age (interquartile range [IQR]) was 35 (25–45) years, 80% were male, 91% black, 60% men who have sex with men, 57% uninsured, and 44% active substance users. TVS decreased from 77 (62–96) to 57 (41–70) days (P < .0022). Time to first attended provider visit decreased from 17 to 5 days, and TAI from 21 to 7 days (P < .0001), each remaining significant in adjusted models. Conclusions This is the largest rapid entry cohort described in the United States and suggests that rapid entry is feasible and could have a positive impact on HIV transmission at the population level.

scholarly journals Birth Cohort Variations Across Functional Knowledge of HIV Prevention Strategies, Perceived Risk, and HIV-Associated Behaviors Among Gay, Bisexual, and Other Men Who Have Sex With Men in the United States

2018 ◽  
Vol 12 (6) ◽  
pp. 1824-1834 ◽  
Author(s):  
Akshay Sharma ◽  
Erin M. Kahle ◽  
Stephen P. Sullivan ◽  
Rob Stephenson
Keyword(s):  
Hiv Prevention ◽  
Birth Cohort ◽  
Perceived Risk ◽  
The United States ◽  
Prevention Strategies ◽  
The Past ◽  
Hiv Prevention Strategies ◽  
Functional Knowledge ◽  
Sex With Men ◽  
Exposure Prophylaxis

Gay, bisexual, and other men who have sex with men (GBMSM) in the United States remain heavily impacted by HIV. The purpose of this study was to describe intergenerational differences in functional knowledge of HIV prevention strategies, perceived risk, recent condomless anal sex (CAS), and HIV testing behavior. Eight hundred sexually active GBMSM were recruited via Facebook from August to September 2015, and administered a Web-based survey which included 12 multiple-choice questions to elicit data regarding functional knowledge of different HIV prevention approaches (e.g., condom use, pre-exposure prophylaxis post-exposure prophylaxis, treatment as prevention, circumcision). Cumulative logit and multivariable logistic models were formulated to examine birth cohort variations across four analytic outcomes. Younger generations were significantly more knowledgeable, as were GBMSM with higher education. Non-Hispanic non-White GBMSM and those reporting a bisexual/other sexual orientation had lower functional knowledge. Younger generations were equally concerned about contracting HIV as their older counterparts. Perceived risk was significantly higher among non-Hispanic non-White and Hispanic GBMSM, but lower among those with higher education and those in a relationship. Finally, birth cohort variations with respect to engaging in CAS with ≥2 men in the past 3 months and testing for HIV in the past year were not markedly pronounced. Younger GBMSM might be more knowledgeable about HIV prevention strategies compared to their predecessors, but are equally concerned about contracting HIV. Researchers and practitioners should consider intergenerational and other demographic differences while designing multifaceted HIV prevention programs for GBMSM.

scholarly journals 1701. Added Benefits of Pre-exposure Prophylaxis Use on HIV Incidence with Minimal Changes in Efficiency in the Context of High Treatment Engagement among Men Who Have Sex with Men

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S833-S833
Author(s):  
Alyson L Singleton ◽  
Brandon D Marshall ◽  
Xiao Zang ◽  
Amy S Nunn ◽  
William C Goedel
Keyword(s):  
African American ◽  
Hiv Infection ◽  
Hiv Transmission ◽  
Treatment Engagement ◽  
Hiv Incidence ◽  
Black African ◽  
African American Msm ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
High Treatment

Abstract Background Although there is ongoing debate over the need for substantial increases in PrEP use when antiretroviral treatment confers the dual benefits of reducing HIV-related morbidity and mortality and the risk of HIV transmission, no studies to date have quantified the potential added benefits of PrEP use in settings with high treatment engagement across variable sub-epidemics in the United States. Methods We used a previously published agent-based network model to simulate HIV transmission in a dynamic network of 17,440 Black/African American and White MSM in Atlanta, Georgia from 2015 to 2024 to understand how the magnitude of reductions in HIV incidence attributable to varying levels of PrEP use (0–90%) changes in potential futures where high levels of treatment engagement (i.e. the UNAIDS ‘90-90-90’ goals and eventual ‘95-95-95’ goals) are achieved and maintained, as compared to current levels of treatment engagement in Atlanta (Figure 1). Model inputs related to HIV treatment engagement among Black/African American and White men who have sex with men in Atlanta. A comparison of current levels of treatment engagement (Panel A) to treatment engagement at ‘90-90-90’ (Panel B) and ‘95-95-95’ goals (Panel C). Results Even at achievement and maintenance of ‘90-90-90’ goals, 75% PrEP coverage reduced incidence rates by an additional 67.9% and 74.2% to 1.53 (SI: 1.39, 1.70) and 0.355 (SI: 0.316, 0.391) per 100 person-years for Black/African American and White MSM, respectively (Figure 2), compared to the same scenario with no PrEP use. Additionally, an increase from 15% PrEP coverage to 75% under ‘90-90-90’ goals only increased person-years of PrEP use per HIV infection averted, a measure of efficiency of PrEP, by 8.1% and 10.5% to 26.7 (SI: 25.6, 28.0) and 73.3 (SI: 70.6, 75.7) among Black/African American MSM and White MSM, respectively (Figure 3). Overall (Panel A) and race-stratified (Panel B and Panel C) marginal changes in HIV incidence over ten years among Black/African American and White men who have sex with men in Atlanta across scenarios of varied levels of treatment engagement among agents living with HIV infection and levels of pre-exposure prophylaxis use among HIV-uninfected agents. Note: All changes are calculated within each set of treatment scenarios relative to a scenario where no agents use pre-exposure prophylaxis. Person-years of pre-exposure prophylaxis use per HIV infection averted among Black/African American (Panel A) and White (Panel B) men who have sex with men in Atlanta across scenarios of varied levels of treatment engagement among agents living with HIV infection and levels of pre-exposure prophylaxis use among HIV-uninfected agents. Note: The number of HIV infections averted is calculated within each set of treatment scenarios relative to a scenario where no agents use pre-exposure prophylaxis. Conclusion Even in the context of high treatment engagement, substantial expansion of PrEP use still contributes to meaningful decreases in HIV incidence among MSM with minimal changes in person-years of PrEP use per HIV infection averted, particularly for Black/African American MSM. Disclosures All Authors: No reported disclosures

scholarly journals Qualitative Consumer Research on Acceptance of Long-Acting Pre-Exposure Prophylaxis Products Among Men Having Sex with Men and Medical Practitioners in the United States

2018 ◽  
Vol 34 (10) ◽  
pp. 849-856 ◽  
Author(s):  
Bobby J. Calder ◽  
Robert J. Schieffer ◽  
Ewa Bryndza Tfaily ◽  
Richard D'Aquila ◽  
George J. Greene ◽  
...  
Keyword(s):  
United States ◽  
Consumer Research ◽  
The United States ◽  
Medical Practitioners ◽  
Sex With Men ◽  
Long Acting ◽  
Exposure Prophylaxis
Sign in / Sign up

Export Citation Format

Share Document