Elevated HIV Prevalence and Correlates of PrEP Use Among a Community Sample of Black Men Who Have Sex With Men
BACKGROUND:The HIV epidemic among black men who have sex with men (BMSM) demands urgent public health attention. Pre-exposure prophylaxis (PrEP) is a highly efficacious option for preventing HIV, but characteristics of PrEP use among community samples of BMSM are not well-understood. METHODS:A seria...
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| Veröffentlicht in: | Journal of acquired immune deficiency syndromes (1999) 2018-11, Vol.79 (3), p.339-346 |
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| container_title | Journal of acquired immune deficiency syndromes (1999) |
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| creator | Eaton, Lisa A Matthews, Derrick D Bukowski, Leigh A Friedman, M Ruvel Chandler, Cristian J Whitfield, Darren L Sang, Jordan M Stall, Ron D |
| description | BACKGROUND:The HIV epidemic among black men who have sex with men (BMSM) demands urgent public health attention. Pre-exposure prophylaxis (PrEP) is a highly efficacious option for preventing HIV, but characteristics of PrEP use among community samples of BMSM are not well-understood.
METHODS:A serial cross-sectional survey assessment (N = 4184 BMSM reporting HIV-negative/unsure status) and HIV testing were conducted at Black Gay Pride events in 6 US cities in 2014, 2015, 2016, and 2017.
RESULTS:HIV prevalence was higher among BMSM self-reporting current PrEP use (1 of 3 participants) than BMSM not self-reporting current PrEP use (1 of 5 participants) [32.3%, N = 103/319 vs. 20.0%, N = 639/3,193, adjusted odds ratio (aOR) = 1.68, 95% confidence interval (CI)1.31 to 2.15]. BMSM reporting current PrEP use (N = 380) were more likely to report having a greater number of male sex partners (aOR = 1.02, 95% CI1.01 to 1.03), a sexually transmitted infection diagnosis (aOR = 2.44, 95% CI1.88 to 3.16), and stimulant drug use (aOR = 2.05, 95% CI, 1.21 to 3.47) when compared with BMSM not reporting current PrEP use (N = 3804). PrEP use increased from 4.7% (2014) to 15.5% (2017) (aOR = 1.19, 95% CI1.13 to 1.25). Among PrEP users, inability to afford health care coverage was associated with testing HIV-positive (aOR = 2.10, 95% CI1.24 to 3.56).
CONCLUSIONS:The high prevalence of HIV infection among BMSM reporting PrEP use is concerning. It does not, however, challenge the efficacy of PrEP itself but rather the uptake of the surrounding preventative package including behavioral risk reduction support, sexually transmitted infection treatment, and medication adherence counseling. Further research to understand barriers to fully effective PrEP is needed to guide operational and behavioral interventions that close the gap on incident infection. |
| doi_str_mv | 10.1097/QAI.0000000000001822 |
| format | Article |
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METHODS:A serial cross-sectional survey assessment (N = 4184 BMSM reporting HIV-negative/unsure status) and HIV testing were conducted at Black Gay Pride events in 6 US cities in 2014, 2015, 2016, and 2017.
RESULTS:HIV prevalence was higher among BMSM self-reporting current PrEP use (1 of 3 participants) than BMSM not self-reporting current PrEP use (1 of 5 participants) [32.3%, N = 103/319 vs. 20.0%, N = 639/3,193, adjusted odds ratio (aOR) = 1.68, 95% confidence interval (CI)1.31 to 2.15]. BMSM reporting current PrEP use (N = 380) were more likely to report having a greater number of male sex partners (aOR = 1.02, 95% CI1.01 to 1.03), a sexually transmitted infection diagnosis (aOR = 2.44, 95% CI1.88 to 3.16), and stimulant drug use (aOR = 2.05, 95% CI, 1.21 to 3.47) when compared with BMSM not reporting current PrEP use (N = 3804). PrEP use increased from 4.7% (2014) to 15.5% (2017) (aOR = 1.19, 95% CI1.13 to 1.25). Among PrEP users, inability to afford health care coverage was associated with testing HIV-positive (aOR = 2.10, 95% CI1.24 to 3.56).
CONCLUSIONS:The high prevalence of HIV infection among BMSM reporting PrEP use is concerning. It does not, however, challenge the efficacy of PrEP itself but rather the uptake of the surrounding preventative package including behavioral risk reduction support, sexually transmitted infection treatment, and medication adherence counseling. Further research to understand barriers to fully effective PrEP is needed to guide operational and behavioral interventions that close the gap on incident infection.</description><identifier>ISSN: 1525-4135</identifier><identifier>ISSN: 1944-7884</identifier><identifier>EISSN: 1944-7884</identifier><identifier>DOI: 10.1097/QAI.0000000000001822</identifier><identifier>PMID: 30063650</identifier><language>eng</language><publisher>United States: Copyright Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Adolescent ; Adult ; Black or African American ; Black People ; Chemoprevention - statistics & numerical data ; Cities - epidemiology ; Communities ; Confidence intervals ; Cross-Sectional Studies ; Disease prevention ; Drug Utilization - statistics & numerical data ; Epidemics ; Female ; Health care ; Health risks ; HIV ; HIV Infections - epidemiology ; HIV Infections - prevention & control ; Homosexuality, Male ; Human immunodeficiency virus ; Humans ; Infections ; Male ; Medical diagnosis ; Pre-Exposure Prophylaxis - statistics & numerical data ; Prevalence ; Prophylaxis ; Public health ; Risk management ; Risk reduction ; Risk taking ; Sexually transmitted diseases ; STD ; United States - epidemiology ; Young Adult</subject><ispartof>Journal of acquired immune deficiency syndromes (1999), 2018-11, Vol.79 (3), p.339-346</ispartof><rights>Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.</rights><rights>Copyright Lippincott Williams & Wilkins Ovid Technologies Nov 1, 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4852-adecb37555a6d13ae9c87ce1d07543c6da3c48d6ac8488ab8c426c9f1d0235573</citedby><cites>FETCH-LOGICAL-c4852-adecb37555a6d13ae9c87ce1d07543c6da3c48d6ac8488ab8c426c9f1d0235573</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,781,785,886,27929,27930</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30063650$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Eaton, Lisa A</creatorcontrib><creatorcontrib>Matthews, Derrick D</creatorcontrib><creatorcontrib>Bukowski, Leigh A</creatorcontrib><creatorcontrib>Friedman, M Ruvel</creatorcontrib><creatorcontrib>Chandler, Cristian J</creatorcontrib><creatorcontrib>Whitfield, Darren L</creatorcontrib><creatorcontrib>Sang, Jordan M</creatorcontrib><creatorcontrib>Stall, Ron D</creatorcontrib><creatorcontrib>POWER Study Team</creatorcontrib><creatorcontrib>The POWER Study Team</creatorcontrib><title>Elevated HIV Prevalence and Correlates of PrEP Use Among a Community Sample of Black Men Who Have Sex With Men</title><title>Journal of acquired immune deficiency syndromes (1999)</title><addtitle>J Acquir Immune Defic Syndr</addtitle><description>BACKGROUND:The HIV epidemic among black men who have sex with men (BMSM) demands urgent public health attention. Pre-exposure prophylaxis (PrEP) is a highly efficacious option for preventing HIV, but characteristics of PrEP use among community samples of BMSM are not well-understood.
METHODS:A serial cross-sectional survey assessment (N = 4184 BMSM reporting HIV-negative/unsure status) and HIV testing were conducted at Black Gay Pride events in 6 US cities in 2014, 2015, 2016, and 2017.
RESULTS:HIV prevalence was higher among BMSM self-reporting current PrEP use (1 of 3 participants) than BMSM not self-reporting current PrEP use (1 of 5 participants) [32.3%, N = 103/319 vs. 20.0%, N = 639/3,193, adjusted odds ratio (aOR) = 1.68, 95% confidence interval (CI)1.31 to 2.15]. BMSM reporting current PrEP use (N = 380) were more likely to report having a greater number of male sex partners (aOR = 1.02, 95% CI1.01 to 1.03), a sexually transmitted infection diagnosis (aOR = 2.44, 95% CI1.88 to 3.16), and stimulant drug use (aOR = 2.05, 95% CI, 1.21 to 3.47) when compared with BMSM not reporting current PrEP use (N = 3804). PrEP use increased from 4.7% (2014) to 15.5% (2017) (aOR = 1.19, 95% CI1.13 to 1.25). Among PrEP users, inability to afford health care coverage was associated with testing HIV-positive (aOR = 2.10, 95% CI1.24 to 3.56).
CONCLUSIONS:The high prevalence of HIV infection among BMSM reporting PrEP use is concerning. It does not, however, challenge the efficacy of PrEP itself but rather the uptake of the surrounding preventative package including behavioral risk reduction support, sexually transmitted infection treatment, and medication adherence counseling. Further research to understand barriers to fully effective PrEP is needed to guide operational and behavioral interventions that close the gap on incident infection.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Black or African American</subject><subject>Black People</subject><subject>Chemoprevention - statistics & numerical data</subject><subject>Cities - epidemiology</subject><subject>Communities</subject><subject>Confidence intervals</subject><subject>Cross-Sectional Studies</subject><subject>Disease prevention</subject><subject>Drug Utilization - statistics & numerical data</subject><subject>Epidemics</subject><subject>Female</subject><subject>Health care</subject><subject>Health risks</subject><subject>HIV</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Infections - prevention & control</subject><subject>Homosexuality, Male</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Infections</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Pre-Exposure Prophylaxis - statistics & numerical data</subject><subject>Prevalence</subject><subject>Prophylaxis</subject><subject>Public health</subject><subject>Risk management</subject><subject>Risk reduction</subject><subject>Risk taking</subject><subject>Sexually transmitted diseases</subject><subject>STD</subject><subject>United States - epidemiology</subject><subject>Young Adult</subject><issn>1525-4135</issn><issn>1944-7884</issn><issn>1944-7884</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9PGzEQxa2qVaHQb1BVlnrpZan_7novlUKUNpGooKKUo-V4J-yC107t3VC-fR0FEHCoL2PP-82TRw-hD5QcUVJXX35OFkfkyaGKsVdon9ZCFJVS4nW-SyYLQbncQ-9Sus5MKUT9Fu1xQkpeSrKP_MzBxgzQ4PniNz6L-eHAW8DGN3gaYgSX1YTDKouzM3yRAE_64K-wyXLfj74b7vC56dcOttCxM_YG_wCPL9uA52YD-Bz-4stuaLfdQ_RmZVyC9_f1AF18m_2azouT0--L6eSksEJJVpgG7JJXUkpTNpQbqK2qLNCGVFJwWzaGZ7ApjVVCKbNUVrDS1qsMMC5lxQ_Q153velz20FjwQzROr2PXm3ing-n0c8V3rb4KG11KSgij2eDzvUEMf0ZIg-67ZME54yGMSTOiqJSMVlv00wv0OozR5_U0o6yua5bJTIkdZWNIKcLq8TOU6G2gOgeqXwaaxz4-XeRx6CHBDKgdcBvcADHduPEWom7BuKH9v_c_dcOrMw</recordid><startdate>20181101</startdate><enddate>20181101</enddate><creator>Eaton, Lisa A</creator><creator>Matthews, Derrick D</creator><creator>Bukowski, Leigh A</creator><creator>Friedman, M Ruvel</creator><creator>Chandler, Cristian J</creator><creator>Whitfield, Darren L</creator><creator>Sang, Jordan M</creator><creator>Stall, Ron D</creator><general>Copyright Wolters Kluwer Health, Inc. All rights reserved</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7T5</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20181101</creationdate><title>Elevated HIV Prevalence and Correlates of PrEP Use Among a Community Sample of Black Men Who Have Sex With Men</title><author>Eaton, Lisa A ; Matthews, Derrick D ; Bukowski, Leigh A ; Friedman, M Ruvel ; Chandler, Cristian J ; Whitfield, Darren L ; Sang, Jordan M ; Stall, Ron D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4852-adecb37555a6d13ae9c87ce1d07543c6da3c48d6ac8488ab8c426c9f1d0235573</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Black or African American</topic><topic>Black People</topic><topic>Chemoprevention - statistics & numerical data</topic><topic>Cities - epidemiology</topic><topic>Communities</topic><topic>Confidence intervals</topic><topic>Cross-Sectional Studies</topic><topic>Disease prevention</topic><topic>Drug Utilization - statistics & numerical data</topic><topic>Epidemics</topic><topic>Female</topic><topic>Health care</topic><topic>Health risks</topic><topic>HIV</topic><topic>HIV Infections - epidemiology</topic><topic>HIV Infections - prevention & control</topic><topic>Homosexuality, Male</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Infections</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>Pre-Exposure Prophylaxis - statistics & numerical data</topic><topic>Prevalence</topic><topic>Prophylaxis</topic><topic>Public health</topic><topic>Risk management</topic><topic>Risk reduction</topic><topic>Risk taking</topic><topic>Sexually transmitted diseases</topic><topic>STD</topic><topic>United States - epidemiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Eaton, Lisa A</creatorcontrib><creatorcontrib>Matthews, Derrick D</creatorcontrib><creatorcontrib>Bukowski, Leigh A</creatorcontrib><creatorcontrib>Friedman, M Ruvel</creatorcontrib><creatorcontrib>Chandler, Cristian J</creatorcontrib><creatorcontrib>Whitfield, Darren L</creatorcontrib><creatorcontrib>Sang, Jordan M</creatorcontrib><creatorcontrib>Stall, Ron D</creatorcontrib><creatorcontrib>POWER Study Team</creatorcontrib><creatorcontrib>The POWER Study Team</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Eaton, Lisa A</au><au>Matthews, Derrick D</au><au>Bukowski, Leigh A</au><au>Friedman, M Ruvel</au><au>Chandler, Cristian J</au><au>Whitfield, Darren L</au><au>Sang, Jordan M</au><au>Stall, Ron D</au><aucorp>POWER Study Team</aucorp><aucorp>The POWER Study Team</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Elevated HIV Prevalence and Correlates of PrEP Use Among a Community Sample of Black Men Who Have Sex With Men</atitle><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle><addtitle>J Acquir Immune Defic Syndr</addtitle><date>2018-11-01</date><risdate>2018</risdate><volume>79</volume><issue>3</issue><spage>339</spage><epage>346</epage><pages>339-346</pages><issn>1525-4135</issn><issn>1944-7884</issn><eissn>1944-7884</eissn><abstract>BACKGROUND:The HIV epidemic among black men who have sex with men (BMSM) demands urgent public health attention. Pre-exposure prophylaxis (PrEP) is a highly efficacious option for preventing HIV, but characteristics of PrEP use among community samples of BMSM are not well-understood.
METHODS:A serial cross-sectional survey assessment (N = 4184 BMSM reporting HIV-negative/unsure status) and HIV testing were conducted at Black Gay Pride events in 6 US cities in 2014, 2015, 2016, and 2017.
RESULTS:HIV prevalence was higher among BMSM self-reporting current PrEP use (1 of 3 participants) than BMSM not self-reporting current PrEP use (1 of 5 participants) [32.3%, N = 103/319 vs. 20.0%, N = 639/3,193, adjusted odds ratio (aOR) = 1.68, 95% confidence interval (CI)1.31 to 2.15]. BMSM reporting current PrEP use (N = 380) were more likely to report having a greater number of male sex partners (aOR = 1.02, 95% CI1.01 to 1.03), a sexually transmitted infection diagnosis (aOR = 2.44, 95% CI1.88 to 3.16), and stimulant drug use (aOR = 2.05, 95% CI, 1.21 to 3.47) when compared with BMSM not reporting current PrEP use (N = 3804). PrEP use increased from 4.7% (2014) to 15.5% (2017) (aOR = 1.19, 95% CI1.13 to 1.25). Among PrEP users, inability to afford health care coverage was associated with testing HIV-positive (aOR = 2.10, 95% CI1.24 to 3.56).
CONCLUSIONS:The high prevalence of HIV infection among BMSM reporting PrEP use is concerning. It does not, however, challenge the efficacy of PrEP itself but rather the uptake of the surrounding preventative package including behavioral risk reduction support, sexually transmitted infection treatment, and medication adherence counseling. Further research to understand barriers to fully effective PrEP is needed to guide operational and behavioral interventions that close the gap on incident infection.</abstract><cop>United States</cop><pub>Copyright Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>30063650</pmid><doi>10.1097/QAI.0000000000001822</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Black or African American Black People Chemoprevention - statistics & numerical data Cities - epidemiology Communities Confidence intervals Cross-Sectional Studies Disease prevention Drug Utilization - statistics & numerical data Epidemics Female Health care Health risks HIV HIV Infections - epidemiology HIV Infections - prevention & control Homosexuality, Male Human immunodeficiency virus Humans Infections Male Medical diagnosis Pre-Exposure Prophylaxis - statistics & numerical data Prevalence Prophylaxis Public health Risk management Risk reduction Risk taking Sexually transmitted diseases STD United States - epidemiology Young Adult |
| title | Elevated HIV Prevalence and Correlates of PrEP Use Among a Community Sample of Black Men Who Have Sex With Men |
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