At-risk people know PrEP prevents HIV but few take it

"It was surprising that so few participants were using PrEP, but we were happy to see that there were no racial or ethnic disparities in who was using it," says Caleb LoSchiavo. (Credit: Tony Webster/Flickr)

Cisgender sexual minority men and transgender women are aware of pre-exposure prophylaxis (PrEP), a daily pill for HIV-negative people to prevent HIV infection, but few currently take it, researchers report.

For the study in the journal AIDS and Behavior, researchers surveyed 202 young sexual minority men and transgender women—two high-priority populations for HIV prevention—to better understand why some were more likely than others to take PrEP.

According to the Centers for Disease Control and Prevention, sexual minority men are the community most affected by HIV, making up 69% of all new diagnoses in 2018, and transgender populations are disproportionately affected by HIV and prevention challenges.

While Black and Hispanic/Latinx populations are mostly likely to be newly diagnosed with HIV, PrEP users are more likely to be white.

The researchers, who are part of the Rutgers School of Public Health’s Center for Health, Identity, Behavior, and Prevention Studies (CHIBPS), found that while 98% of the study’s participants were aware of PrEP, less than 25% were currently taking it.

“It was surprising that so few participants were using PrEP, but we were happy to see that there were no racial or ethnic disparities in who was using it,” says study coauthor Caleb LoSchiavo, a doctoral candidate at the Rutgers School of Public Health. “I think the study results point to the effectiveness of local efforts to increase the use of PrEP for those who need it most.”

While the study found unexpected equity in PrEP use, it also pointed to racial and ethnic differences in factors associated with its use.

White participants’ likelihood of using PrEP increased with age and decreased if they reported concerns about daily medication use. However, participants of color were more likely to take PrEP if they received information about the HIV prevention pill from a health care provider and if they had more positive beliefs about its use.

“Our study highlights the importance of clinicians in expanding the use of HIV prevention methods like PrEP among those who need it most, both through informing their patients about PrEP and through combating stigmatizing beliefs about PrEP use,” says senior study author Perry N. Halkitis, dean of the Rutgers School of Public Health and director of CHIBPS.

The study underscores the importance of PrEP education in clinical settings, the researchers say.
“Positive public health messaging about PrEP must reframe risk, combat stigma and normalize preventive healthcare,” LoSchiavo says.

Additional coauthors are from the University of Alabama and Yale University School of Public Health.

Source: Rutgers University