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Factors Associated with Pre-exposure Prophylaxis in a Highly Insured Population of Urban Men Who Have Sex with Men, 2014

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Abstract

In the United States, an estimated 25% of men who have sex with men (MSM) have indications for receiving pre-exposure prophylaxis to prevent HIV infection (PrEP), but <4% reported PrEP use in the past 12 months. We evaluate factors associated with having heard of, willingness to use, and use of PrEP in a venue-based, time-spaced sample of 316 urban, highly insured Boston MSM in the 2014 NHBS. We found that 53.7% of respondents reported receiving usual medical care from a doctor’s office or health maintenance organization, 57.6% had an indication for PrEP, 66.6% had heard of PrEP, 53.6% reported willingness to use PrEP, and 5.8% reported use of PrEP in the past 12 months. In multivariable analyses, an indication for PrEP was statistically associated with having heard of, willingness to use and use of PrEP in the past 12 months. Findings guide statewide efforts to evaluate and promote PrEP.

Resumen

Mientras que el 25% de los hombres homosexuales en Estados Unidos pueden tener una indicación para tomar profilaxis pre exposición a VIH (PrEP), <4% reportan su uso. Entrevistamos a 316 hombres homosexuales en la ciudad de Boston, donde el >97% de la población tiene seguro de salud. Los resultados indican que 57.6% de los participantes tenían alguna indicación para PrEP, que 66.6% tenía conocimiento de la disponibilidad de PrEP, que 53.6% estaba dispuesta a tomar PrEP y 5.8% usó PrEP en los últimos 12 meses. El análisis multifactorial encontró que había una asociación significativa entre tener una indicación para PrEP y el conocimiento, la disposición a tomarlo, y el uso de PrEP. Estos hallazgos sirven para evaluar y promover el uso de PrEP en Massachusetts para lograr una reducción de 30% en el número de diagnósticos nuevos de VIH en hombres homosexuales antes del 2021.

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References

  1. Grant RM, Lama JR, Anderson PL, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363:2587–99.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Molina JM, Capitant C, Spire B, et al. On-demand preexposure prophylaxis in men at high risk for HIV-1 infection. N Engl J Med. 2015;373:2237–46.

    Article  CAS  PubMed  Google Scholar 

  3. Wu H, Mendoza MCB, Huang YA, Hayes T, Smith DK, Hoover KW. Uptake of HIV preexposure prophylaxis among commercially insured persons—United States, 2010–2014. Clin Infect Dis. 2017;64(2):144–9.

    Article  PubMed  Google Scholar 

  4. CDC/USPHS. Preexposure prophylaxis for the prevention Of HIV infection in the United States—2014. A clinical practice guideline. https://www.cdc.gov/hiv/pdf/guidelines/PrEPguidelines2014.pdf. Accessed 30 Dec 2015.

  5. Smith DK, Van Handel M, Wolitski RJ, et al. Vital signs: estimated percentages and numbers of adults with indications for preexposure prophylaxis to prevent HIV acquisition—United States, 2015. MMWR. 2015;64:1291–5.

    PubMed  Google Scholar 

  6. Hoots BE, Finlayson T, Nerlander L, Paz-Bailey G, National HIV, Behavioral Surveillance Study Group. Willingness to take, use of, and indications for pre-exposure prophylaxis among men who have sex with men-20 US cities, 2014. Clin Infect Dis. 2016;63(5):672–7.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Kaiser Family Foundation. Massachusetts healthcare reform: six years later. Focus on health reform, May 2012. Publication #8311. https://kaiserfamilyfoundation.files.wordpress.com/2013/01/8311.pdf. Accessed 25 Nov 2016.

  8. Massachusetts Department of Public Health. Massachusetts HIV epidemic at a glance. http://www.mass.gov/eohhs/docs/dph/aids/2015-profiles/epidemic-glance.pdf. Accessed 14 Mar 2017.

  9. Campaign is at Mass.gov PrEP. http://www.mass.gov/eohhs/gov/departments/dph/programs/id/hiv-aids/pre-exposure-prophylaxis-prep.html.

  10. BIDLS. HIV/AIDS services in Massachusetts. http://www.mass.gov/eohhs/docs/dph/aids/scsn.pdf. Accessed 25 Nov 2016.

  11. Gallagher KM, Sullivan PS, Lansky A, Onorato IM. Behavioral surveillance among people at risk for HIV infection in the U.S.: the National HIV Behavioral Surveillance System. Public Health Rep. 2007;122(Suppl 1):32–8.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Cranston K, John B, Fukuda HD, Randall LM, Mermin J, Mayer KH, DeMaria A Jr. Sustained reduction in HIV diagnoses in Massachusetts, 2000–2014. Am J Public Health. 2017;107(5):794–9.

    Article  PubMed  Google Scholar 

  13. Massachusetts Department of Public Health. Massachusetts epidemiologic profile, 2016. http://www.mass.gov/eohhs/gov/departments/dph/programs/id/hiv-aids/epi-profile/epi-2016/population-specific-fact-sheets.html. Accessed 14 Mar 2017.

  14. Drabo EF, Hay JW, Vardavas R, Wagner ZR, Sood N. A cost-effectiveness analysis of preexposure prophylaxis for the prevention of HIV among Los Angeles County men who have sex with men. CID. 2016;63:1495–504.

    Article  Google Scholar 

  15. Laufer FN, O’Connell DA, Feldman I, Zucker HA. Vital signs: increased Medicaid prescriptions for preexposure prophylaxis against HIV infection—New York, 2012–2015. MMWR. 2015;64:1296–301.

    PubMed  Google Scholar 

  16. Emory University. American Men’s Internet Survey (AMIS): online HIV behavioral survey of men who have sex with men, California, 2014. PRISM Health, Emory University, Atlanta, GA, June 2015.

  17. Jenness SM, Goodreau SM, Rosenberg E, Beylerian EN, Hoover KW, Smith DK, Sullivan P. Impact of the centers for disease control’s HIV preexposure prophylaxis guidelines for men who have sex with men in the United States. JID. 2016;214:1800–7.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

Field components were conducted by Chris Wittke and Justin Hinchey of the AIDS Action Committee of Massachusetts. This study was funded by the Centers for Disease Control and Prevention Cooperative Agreement No. U1BPS003254-05.

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Correspondence to R. Monina Klevens.

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Conflict of interest

All authors declare that they have no conflicts of interest: Klevens, Doherty, Fukuda, Cranston and DeMaria were employees of the Massachusetts Department of Public Health. Author Martin was an employee of non-profit Boston University and received no additional funding for this project.

Ethical Approval

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. Protocol was reviewed and approved by the Massachusetts Department of Public Health Institutional Review Board.

Informed Consent

Informed consent was obtained from all individual participants included in the study using instruments in English and Spanish; consent forms were approved by the Massachusetts Department of Public Health Institutional Review Board.

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Klevens, R.M., Martin, B.M., Doherty, R. et al. Factors Associated with Pre-exposure Prophylaxis in a Highly Insured Population of Urban Men Who Have Sex with Men, 2014. AIDS Behav 22, 1201–1208 (2018). https://doi.org/10.1007/s10461-017-1879-2

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