Demographic, Behavioral, and Geographic Differences Between Men, Transmen, and Transwomen Currently on PrEP, Former PrEP Users, and Those Having Never Used PrEP

  • Drew A. Westmoreland
  • David W. Pantalone
  • Viraj V. Patel
  • Donald Hoover
  • Denis Nash
  • Christian GrovEmail author
Original Paper


Many recent studies have compared men currently taking pre-exposure prophylaxis (PrEP) to men not taking PrEP. However, less is known about demographic, behavioral, and geographic characteristics of men formerly, but not currently, taking PrEP. Using a 2017–2018 U.S. national, internet-based sample (n = 10,504) of men, transmen, and transwomen who have sex with men, we compared three groups based on their PrEP experiences. Results highlight individual-level financial and geo-contextual barriers to PrEP use that can inform prevention efforts to improve PrEP initiation and continuation for both PrEP-naïve and PrEP-experienced individuals, respectively.


Pre-exposure prophylaxis, PrEP Gay and bisexual men Sexual behavior Demographic characteristics 


Muchos estudios recientes han comparado a hombres que actualmente toman PrEP con hombres que no toman PrEP. Sin embargo, se conoce menos sobre las características demográficas, conductuales y geográficas de los hombres que antes, pero no actualmente, tomaban PrEP. Utilizando una muestra nacional de los EE. UU. obtenida de Internet entre el 2017–2018 (n = 10,504) de hombres, hombres transgénero y mujeres transgénero que tienen sexo con hombres, comparamos tres grupos basado en sus experiencias con PrEP. Los resultados destacan barreras financieras a nivel individual, y barreras geo-contextuales al uso de PrEP que pueden informar los esfuerzos de prevención para mejorar la iniciación y la continuación de PrEP tanto de individuos sin experiencia previa con PrEP como y aquellos con experiencia, respectivamente.



Special thanks to additional members of the T5K study team: Matthew Stief, Caitlin MacCrate, Chloe Mirzayi, Sarah Kulkarni, Gloria Perez, Irvin Parker, & Pedro Carneiro. Thank you to Javier Lopez-Rios, a member of the T5K study team, for translating the abstract into Spanish. Special thanks to Alexa D’Angelo, a member of the T5K study team, and Evan Krueger for editing this report. Thank you to the program staff at NIH: Gerald Sharp, Sonia Lee, and Michael Stirratt. And thank you to the members of our Scientific Advisory Board: Sarit Golub, Gregorio Millett, Michael Camacho, Adam Carrico, Demetre Daskalakis, Sabina Hirshfield, Jeremiah Johnson, Claude Mellins, and Milo Santos. Finally, this work would not be possible without the participation T5K cohort members.


Together 5000 was funded by the National Institutes of Health (UG3 AI 133675 - PI Grov). Viraj Patel was supported by a career development award (K23 MH 102118). Other forms of support include the CUNY Institute for Implementation Science in Population Health, and the Einstein, Rockefeller, CUNY Center for AIDS Research (ERC CFAR, P30 AI 124414).

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Drew A. Westmoreland
    • 1
  • David W. Pantalone
    • 2
    • 3
  • Viraj V. Patel
    • 4
  • Donald Hoover
    • 5
  • Denis Nash
    • 1
    • 6
  • Christian Grov
    • 1
    • 6
    Email author
  1. 1.Institute for Implementation Science in Population Health (ISPH)City University of New YorkNew YorkUSA
  2. 2.Department of PsychologyUniversity of MassachusettsBostonUSA
  3. 3.The Fenway InstituteFenway HealthBostonUSA
  4. 4.Division of General Internal Medicine, Montefiore Health SystemAlbert Einstein College of MedicineBronxUSA
  5. 5.Department of Statistics and BiostatisticsRutgers UniversityNew BrunswickUSA
  6. 6.Graduate School of Public Health and Health PolicyCity University of New YorkNew YorkUSA

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