Home-based pre-exposure prophylaxis (PrEP) services for gay and bisexual men: An opportunity to address barriers to PrEP uptake and persistence

Gay, bisexual, and other men who have sex with men (GBM) are disproportionately affected by the HIV epidemic. Despite the promise of pre-exposure prophylaxis (PrEP) in reducing HIV transmission risk, barriers for uptake and persistence exist. We sought to identify whether GBM in a nationwide cohort...

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Veröffentlicht in:PloS one 2017-12, Vol.12 (12), p.e0189794-e0189794
Hauptverfasser: John, Steven A, Rendina, H Jonathon, Grov, Christian, Parsons, Jeffrey T
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Rendina, H Jonathon
Grov, Christian
Parsons, Jeffrey T
description Gay, bisexual, and other men who have sex with men (GBM) are disproportionately affected by the HIV epidemic. Despite the promise of pre-exposure prophylaxis (PrEP) in reducing HIV transmission risk, barriers for uptake and persistence exist. We sought to identify whether GBM in a nationwide cohort who have not yet initiated PrEP (n = 906) would prefer to get PrEP-related care from a primary care provider (PCP) compared to a specialist clinic or provider. We then sought to identify their level of interest and factors associated with preference for using home-based PrEP services (i.e., HB-PrEP), defined to participants as conducting HIV/STI self-testing from home with PrEP prescription mailing after an initial in-person clinic visit. We examined the associations of demographics, sexual HIV transmission risk, concern about frequent medical checkups associated with PrEP, health care access, and PrEP intentions with preferences for healthcare provider type and HB-PrEP. Concern about frequent medical checkups were associated with preferring a PCP for PrEP-related care, but men who perceived a barrier to bringing up the topic of PrEP with a doctor preferred a specialist clinic or provider more than a PCP. HB-PrEP was more appealing for younger men and those engaged in sexual HIV transmission risk, suggesting HB-PrEP could help reach GBM most vulnerable to HIV and in need of PrEP. HB-PrEP expansion has potential to increase PrEP uptake and persistence among GBM, particularly for men with barriers to clinic-based care and higher intentions to initiate PrEP. Clinical guidelines regarding HB-PrEP are needed to expand its use.
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subjects Acquired immune deficiency syndrome
AIDS
Behavior
Biology and Life Sciences
Bisexual
Bisexuality
Bisexuals
Comparative analysis
Demographics
Demography
Disease transmission
Diseases
Epidemics
Exposure
Gays
Gays & lesbians
Health care
Health risks
HIV
HIV infections
Human immunodeficiency virus
Medicine and Health Sciences
Men
Methods
People and Places
Physical Sciences
Physiological aspects
Prevention
Prophylaxis
Research and Analysis Methods
Risk
Risk factors
Sexually transmitted diseases
Social Sciences
STD
Studies
title Home-based pre-exposure prophylaxis (PrEP) services for gay and bisexual men: An opportunity to address barriers to PrEP uptake and persistence
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