Health Care-Seeking Behaviors and Perceptions of Provider-Initiated Discussion of Pre-exposure Prophylaxis Among PrEP-Naive HIV-Negative Men Who Have Sex With Men in Atlanta, Georgia

• Type of Material: Article
• Authors: Susanna L. Trost, Emory University; Udodirim N. Onwubiko, Fulton City Board of Health; Derick B. Wilson, Fulton City Board of Health; David Holland, Emory University; Allison T. Chamberlain, Emory University
• Language: English
• Date: 2020-05-01
• Publisher: Oxford University Press (OUP)
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1093/ofid/ofaa165
• Title of Journal or Parent Work: Open Forum Infectious Diseases
• ISSN: 2328-8957
• Volume: 7
• Issue: 5
• Start Page: ofaa165
• End Page: ofaa165
• Grant/Funding Information: This work was supported in part by the National Institutes of Health Center for AIDS Research at Emory University (grant number P30AI050409) to A.T.C.; This article published with support from Emory Libraries' Open Access Publishing Fund.
• Keywords: Infectious Diseases; INFECTION; PREVENTION; Immunology; HIV; AWARENESS; MSM; pre-exposure prophylaxis; PrEP promotion; IMPLEMENTATION; Science & Technology; Microbiology; primary care; Life Sciences & Biomedicine
• Research Categories: Health Sciences, Immunology; Biology, Microbiology

Abstract

Background: Given high rates of HIV among men who have sex with men (MSM) in the United States, there is a need to more effectively leverage the health care system to bolster promotion of pre-exposure prophylaxis (PrEP) to at-risk MSM. Methods: Using data collected from a 2018 venue-based cross-sectional survey, we examined factors associated with health care-seeking behaviors, discussing PrEP with a provider, and barriers to PrEP uptake among MSM. Associations between outcomes and respondents' sociodemographic characteristics and sexual behaviors were assessed using log binomial regression. Results: Of 478 MSM, 247 (51%) were PrEP-naïve and HIV-negative. Although 85% of PrEP-naïve MSM reported visiting a health care provider in the past year, only 31% recalled having any provider discuss PrEP. The most frequently cited reasons for not taking PrEP were low perception of personal risk of acquiring HIV (37%) and not knowing enough about PrEP (35%). Those who saw a provider in the last year were less likely than those who did not to cite lack of knowledge as a barrier to use (prevalence rate, 0.66, 95% confidence interval, 0.45-0.96). Conclusions: Despite the majority of PrEP-naïve MSM interfacing with the health care system, recollection of discussing PrEP with providers was limited. Increased efforts to equip providers with the tools to discuss PrEP and address pressing concerns with at-risk individuals may help improve PrEP uptake among priority populations.