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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
  • 29 Downloads

Abstract

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.

Keywords

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

Resumen

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.

Notes

Acknowledgements

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.

Funding

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.

References

  1. 1.
    Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, National Center for Health Statistics. HIV: Statistics Center (2019). https://www.cdc.gov/hiv/statistics/overview/ataglance.html. Accessed Aug 2019.
  2. 2.
    Fonner VA, Dalglish SL, Kennedy CE, et al. Effectiveness and safety of oral HIV preexposure prophylaxis for all populations. AIDS. 2016;30(12):1973–83.CrossRefGoogle Scholar
  3. 3.
    Siegler AJ, Mouhanna F, Giler RM, et al. The prevalence of pre-exposure prophylaxis use and the pre-exposure prophylaxis-to-need ratio in the fourth quarter of 2017, United States. Ann Epidemiol. 2018;28(12):841–9.CrossRefGoogle Scholar
  4. 4.
    Centers for Disease Control and Prevention. US Public Health Service: preexposure prophylaxis for the prevention of HIV infection in the United States—2017 update: a clinical practice guideline. Atlanta: U.S. Department of Health and Human Services; 2018.Google Scholar
  5. 5.
    Whitfield THF, John SA, Rendina HJ, Grov C, Parsons JT. Why I quit pre-exposure prophylaxis (PrEP)? A mixed-method study exploring reasons for PrEP discontinuation and potential re-initiation among gay and bisexual men. AIDS Behav. 2018;22(11):3566–75.CrossRefGoogle Scholar
  6. 6.
    Marcus JL, Hurley LB, Dentoni-Lasofsky D, et al. Barriers to preexposure prophylaxis use among individuals with recently acquired HIV infection in Northern California. AIDS Care. 2018;31(5):1–9.Google Scholar
  7. 7.
    Morgan E, Ryan DT, Newcomb ME, Mustanski B. High rate of discontinuation may diminish PrEP coverage among young men who have sex with men. AIDS Behav. 2018;22(11):3645–8.CrossRefGoogle Scholar
  8. 8.
    Holloway IW, Dougherty R, Gildner J, et al. Brief Report: PrEP uptake, adherence, and discontinuation among california YMSM using geosocial networking applications. J. Acquir. Immune Defic. Syndr. 2017;74(1):15–20.CrossRefGoogle Scholar
  9. 9.
    Grov C, Westmoreland DA, Carneiro PB, et al. Recruiting vulnerable populations to participate in HIV prevention research: findings from the Together 5000 cohort study. Ann Epidemiol. 2019.  https://doi.org/10.1016/j.annepidem.2019.05.003.CrossRefPubMedGoogle Scholar
  10. 10.
    Henry J Kaiser Family Foundation. Health Reform. 2019; https://www.kff.org/state-category/health-reform/medicaid-and-health-reform-health-reform/. Accessed January, 2019.
  11. 11.
    Siegler AJ, Bratcher A, Weiss KM, Mouhanna F, Ahlschlager L, Sullivan PS. Location location location: an exploration of disparities in access to publicly listed pre-exposure prophylaxis clinics in the United States. Ann Epidemiol. 2018;28(12):858–64.CrossRefGoogle Scholar
  12. 12.
    Garfield R, Damico A, Orgera K The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid 2018 https://www.kff.org/medicaid/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid/. Accessed 29 Oct 2018

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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