Top

Published in:

01-05-2017 | Original Paper

Awareness and Acceptability of Pre-exposure HIV Prophylaxis Among Men Who have Sex with Men in Baltimore

Authors: Susan A. Fallon, Ju Nyeong Park, Christine Powell Ogbue, Colin Flynn, Danielle German

Published in: AIDS and Behavior | Issue 5/2017

Abstract

This paper assessed characteristics associated with awareness of and willingness to take pre-exposure prophylaxis (PrEP) among Baltimore men who have sex with men (MSM). We used data from BESURE-MSM3, a venue-based cross-sectional HIV surveillance study conducted among MSM in 2011. Multivariate regression was used to identify characteristics associated with PrEP knowledge and acceptability among 399 participants. Eleven percent had heard of PrEP, 48% would be willing to use PrEP, and none had previously used it. In multivariable analysis, black race and perceived discrimination against those with HIV were significantly associated with decreased awareness, and those who perceived higher HIV discrimination reported higher acceptability of PrEP. Our findings indicate a need for further education about the potential utility of PrEP in addition to other prevention methods among MSM. HIV prevention efforts should address the link between discrimination and potential PrEP use, especially among men of color.

Centers for Disease Control and Prevention. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas—2012. HIV surveillance supplemental report 2014. 2014; 19(3). http://www.cdc.gov/hiv/pdf/surveillance_Report_vol_19_no_3.pdf

Centers for Disease Control and Prevention. HIV surveillance report, 2012. 2014. http://www.cdc.gov/hiv/pdf/statistics_2012_HIV_Surveillance_Report_vol_24.pdf

Purcell DW, Johnson CH, Lansky A, et al. Estimating the population size of men who have sex with men in the United States to obtain HIV and syphilis rates. Open AIDS J. 2012;6:98–107.CrossRefPubMedPubMedCentral

Centers for Disease Control and Prevention. Estimated HIV incidence in the United States, 2007– 2010. HIV Surveillance Supplemental Report 2012. 2012; 17(4). http://www.cdc.gov/hiv/pdf/statistics_hssr_vol_17_no_4.pdf.

Centers for Disease Control and Prevention. Diagnoses of HIV infection in the United States and dependent areas, 2012. HIV Surveillance Report. 2012; 24. Available at: http://www.cdc.gov/hiv/pdf/statistics_2012_HIV_Surveillance_Report_vol_24.pdf.

Maryland Department of Health and Mental Hygiene. Maryland annual HIV epidemiological profile 2012. Center for HIV Surveillance, Epidemiology and Evaluation. 2015. http://phpa.dhmh.maryland.gov/OIDEOR/CHSE/SiteAssets/SitePages/statistics/Maryland%20HIV%20AIDS%20Epidemiological%20Profile2.pdf

Kelesidis T, Landovitz RJ. Preexposure prophylaxis for HIV prevention. Curr HIV/AIDS Rep. 2002;8(2):94–103.CrossRef

Grant RM, Lama JR, Anderson PL, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. NEJM. 2010;363(27):2587–99.CrossRefPubMedPubMedCentral

Anderson PL, Glidden DV, Liu A, et al. Emtricitabine-tenofovir concentrations and pre-exposure prophylaxis efficacy in men who have sex with men. Sci Transl Med. 2012;4(151):1–5.CrossRef

10.

Centers for Disease Control and Prevention. CDC statement on IPERGAY trial of Pre- exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men, NCHHSTP Newsroom, 2015. http://www.cdc.gov/nchhstp/newsroom/2015/IPERGAY-2015-Media-Statement.html.

11.

Centers for Disease Control and Prevention. Interim guidance: preexposure prophylaxis for the prevention of HIV infection in men who have sex with men. MMWR Morb Mortal Wkly Rep. 2011;60(3):65–8.

12.

Food and Drug Administration. FDA approves first drug for reducing the risk of sexually acquired HIV infection. FDA News Press Release, July 16, 2012.

13.

Yang D, Chariyalertsak C, Wongthanee A, et al. Acceptability of pre-exposure prophylaxis among men who have sex with men and transgender women in northern thailand. PLoS ONE. 2013;8(10):e76650.CrossRefPubMedPubMedCentral

14.

Al-Tayyib AA, Thrun MW, Haukoos JS, Walls NE. Knowledge of pre-exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men in denver, colorado. AIDS Behav. 2014;18(3):340–7.CrossRefPubMedPubMedCentral

15.

Krakower DS, Mimiaga MJ, Rosenberger JG, et al. Limited awareness and low immediate uptake of pre-exposure prophylaxis among men who have sex with men using an internet social networking site. PLoS ONE. 2012;7(3):e33119.CrossRefPubMedPubMedCentral

16.

Zhou F, Gao L, Li S, et al. Willingness to accept HIV pre-exposure prophylaxis among chinese men who have sex with men. PLoS ONE. 2012;7(3):e32329.CrossRefPubMedPubMedCentral

17.

Leonardi M, Lee E, Tan DH. Awareness of, usage of and willingness to use HIV-pre-exposure prophylaxis among men in downtown Toronto, Canada. Int J STD AIDS. 2011;22(12):738–41.CrossRefPubMed

18.

Liu A, Kittredge PV, Vittinghoff E, et al. Limited knowledge and use of HIV post- and pre-exposure prophylaxis among gay and bisexual men. J AIDS. 2008;47(2):241–7.

19.

Mimiaga MJ, Case P, Johnson CV, Safren SA, Mayer KH. Preexposure antiretroviral prophylaxis attitudes in high-risk boston area men who report having sex with men: limited knowledge and experience but potential for increased utilization after education. J AIDS. 2009;50(1):77–83.

20.

Voetsch AC, Heffelfinger JD, Begley EB, Jafa-Bhushan K, Sullivan PS. Knowledge and use of preexposure and postexposure prophylaxis among attendees of minority gay pride events, 2005 through 2006. J AIDS. 2007;46(3):378–80.

21.

Barash EA, Golden M. Awareness and use of HIV pre-exposure prophylaxis among attendees of a seattle gay pride event and sexually transmitted disease clinic. AIDS Patient Care STDS. 2011;24(11):689–91.CrossRef

22.

Kellerman SE, Hutchinson AB, Begley EB, Boyett BC, Clark HA, Sullivan P. Knowledge and use of HIV pre-exposure prophylaxis among attendees of minority gay pride events, 2004. J AIDS. 2006;43(3):376–7.

23.

Mehta SA, Silvera R, Bernstein K, Holzman RS, Aberg JA, Daskalakis DC. Awareness of post-exposure HIV prophylaxis in high-risk men who have sex with men in New York city. Sex Transm Infect. 2011;87(4):344–8.CrossRefPubMed

24.

Rucinski KB, Mensah NP, Sepkowitz KA, Cutler BH, Sweeney MM, Myers JE. Knowledge and use of pre-exposure prophylaxis among an online sample of young men who have sex with men in New York city. AIDS Behav. 2013;17(6):2180–4.CrossRefPubMed

25.

Aghaizu A, Mercey D, Copas A, Johnson AM, Hart G, Nardone A. Who would use PrEP? Factors associated with intention to use among MSM in London: a community survey. Sex Transm Infect. 2013;89(3):207–2011.CrossRefPubMed

26.

Mansergh G, Koblin BA, Colfax GN, McKirnan DJ, Flores SA, Hudson SM. Preefficacy use and sharing of antiretroviral medications to prevent sexually-transmitted HIV infection among US men who have sex with men. J AIDS. 2010;55(2):e14–6.

27.

Lorente N, Fugon L, Carrieri MP, et al. Acceptability of an “on-demand” pre-exposure HIV prophylaxis trial among men who have sex with men living in france. AIDS Care. 2012;24(4):468–77.PubMed

28.

Schneider J, Kumar R, Dandona R, et al. Social network and risk-taking behavior most associated with rapid HIV testing, circumcision, and preexposure prophylaxis acceptability among high-risk indian men. AIDS Patient Care STDS. 2012;26(10):631–40.CrossRefPubMedPubMedCentral

29.

Golub SA, Gamarel KE, Rendina HJ, Surace A, Lelutiu-Weinberger CL. From efficacy to effectiveness: facilitators and barriers to PrEP acceptability and motivations for adherence among MSM and transgender women in new york city. AIDS Patient Care STDS. 2013;27(4):248–54.CrossRefPubMedPubMedCentral

30.

Golub SA, Kowalczyk W, Weinberger CL, Parsons JT. Pre-exposure Prophylaxis and predicted condom use among high-risk men who have sex with men. J AIDS. 2010;54(5):548–55.

31.

Brooks RA, Landovitz RJ, Kaplan RL, Lieber E, Lee SJ, Barkley TW. Sexual risk behaviors and acceptability of HIV pre-exposure prophylaxis among HIV-negative gay and bisexual men in serodiscordant relationships: a mixed methods study. AIDS Patient Care STDS. 2012;26(2):87–94.CrossRefPubMedPubMedCentral

32.

Young I, Li J, McDaid L. Awareness and willingness to use HIV pre-exposure prophylaxis amongst gay and bisexual men in scotland: implications for biomedical HIV prevention. PLoS ONE. 2013;8(5):e64038.CrossRefPubMedPubMedCentral

33.

Saberi P, Gamarel KE, Neilands TB, et al. Ambiguity, ambivalence, and apprehensions of taking HIV-1 pre-exposure prophylaxis among male couples in san francisco: A mixed methods study. PLoS One. 2012;7(11):e50061.CrossRefPubMedPubMedCentral

34.

Galea JT, Kinsler JJ, Salazar X, et al. Acceptability of pre-exposure prophylaxis as an HIV prevention strategy: barriers and facilitators to pre-exposure prophylaxis uptake among at-risk peruvian populations. Int J STD AIDS. 2011;22(5):256–62.CrossRefPubMedPubMedCentral

35.

Jackson T, Huang A, Gao X, Zhong X, Zhang Y. Cognitive. Psychosocial, and Sociodemographic Predictors of Willingness to use HIV pre-exposure prophylaxis among Chinese men who have sex with men, AIDS Behav. 2012;16(7):1853–61.PubMed

36.

Ferreira LO, de Oliveira ES, Raymond HF, Chen SY, McFarland W. Use of time-location sampling for systematic behavioral surveillance of truck drivers in Brazil. AIDS Behav. 2008;12(4 Suppl):S32–8.CrossRefPubMed

37.

MacKellar DA, Gallagher KM, Finlayson T, Sanchez T, Lansky A, Sullivan P. Surveillance of HIV risk and prevention behaviors of men who have sex with men: a national application of venue-based, time-space sampling. Public Health Rep. 2007;122(Suppl 1):39–47.CrossRefPubMedPubMedCentral

38.

Raymond HF, McFarland W. Racial mixing and HIV risk among men who have sex with men. AIDS Behav. 2009;13(4):630–7.CrossRefPubMedPubMedCentral

39.

Centers for Disease Control and Prevention. Prevalence and awareness of HIV infection among men who have sex with men—21 cities, United States, 2008. MMWR Morb Mortal Wkly Rep. 2010;59(37):1201–7.

40.

German D, Sifakis F, Maulsby C, et al. Persistently high prevalence and unrecognized HIV infection among men who have sex with men in Baltimore: the BESURE Study. J Acquir Immune Defic Syndr. 2011;57(1):77–87.CrossRefPubMed

41.

Shoptaw S, Weiss RE, Munjas B, et al. Homonegativity, substance use, sexual risk behaviors, and HIV status in poor and ethnic men who have sex with men in Los Angeles. J Urban Health. 2009;86(Suppl. 1):77–92.CrossRefPubMedPubMedCentral

42.

Icard L. Gay black men and conflicting social identities: sexual orientation versus racial identity. J Soc Work Hum Sex. 1986;4:83–93.CrossRef

43.

Operario D, Smith CD, Kegeles S. Social and psychological context for HIV risk in non-gay-identified African American men who have sex with men. AIDS Educ Prev. 2008;20:347–59.CrossRefPubMed

44.

Williams JK, Wyatt GE, Resell J, Peterson J, Asuan-O’Brien A. Psychosocial issues among gay- and non-gay-identifying HIV-seropositive African American and Latino MSM. Cult Divers Ethn Minor Psychol. 2004;10:268–86.CrossRef

45.

Dodge B, Jeffries WL, Sandfort TG. Beyond the down low: sexual risk, protection, and disclosure among at-risk black men who have sex with both men and women (MSMW). Arch Sex Behav. 2008;37(5):683–96.CrossRefPubMedPubMedCentral

46.

Miller M, Serner M, Wagner M. Drug-using men who have sex with men as bridges for HIV and other sexually transmitted infections: sexual diversity among black men who have sex with men in an inner-city community. J Urban Health. 2005;82(1):i26–34.CrossRefPubMedPubMedCentral

47.

Radcliffe J, Doty N, Hawkins LA, Gaskins CS, Beidas R, Rudy BJ. Stigma and sexual health risk in HIV-positive African American young men who have sex with men. AIDS Patient Care STDS. 2010;24(8):493–9.CrossRefPubMedPubMedCentral

48.

Woodyard JL, Peterson JL, Stokes JP. ‘‘Let us go into the house of the lord’’: participation in African American churches among young African American men who have sex with men. J Pastor Care. 2000;54(4):451–60.

49.

Miller RL Jr. Legacy denied: African American gay men, AIDS, and the black church. Soc Work. 2007;52(1):51–61.CrossRefPubMed

50.

Radcliffe J, Doty N, Hawkins LA, et al. Stigma and sexual health risk in HIV-positive African American young men who have sex with men. AIDS Patient Care STDS. 2010;24(8):493–9.CrossRefPubMedPubMedCentral

51.

Downshen N, Binns H, Garafalo R. Experiences of HIV-related stigma among young men who have sex with men. AIDS Patient Care STDS. 2009;23:371–6.CrossRef

52.

Wright K, Naar-King S, Lam P, et al. Stigma scale revised: reliability and validity of a brief measure of stigma for HIV + youth. J Adol Health. 2007;40:96–8.CrossRef

53.

Johnson M, Carrico A, Chesney M, et al. Internalized heterosexism among HIV-positive, gay-identified men: implications for HIV prevention and care. J Consult Clin Psych. 2008;76:829–39.CrossRef

54.

Glick SN, Golden MR. Persistence of racial differences in attitudes toward homosexuality in the United States. J AIDS. 2010;55(4):516–23.

55.

Abbas UL, Anderson RM, Mellors JW. Potential impact of antiretroviral chemoprophylaxis on HIV-1 transmission in resource-limited settings. PLoS ONE. 2007;2(9):e875.CrossRefPubMedPubMedCentral

56.

Siegel K, Raveis V. Perceptions of access to HIV-related information, care, and services among infected minority men. Qual Health Res. 1997;7(1):9–31.CrossRef

57.

Malebranche DJ, Peterson JL, Fullilove RE, Stackhouse RW. Race and sexual identity: perceptions about medical culture and healthcare among black men who have sex with men. J Natl Med Assoc. 2004;96(1):97–107.PubMedPubMedCentral

58.

Halkitis PN, Parsons JT, Wolitski RJ, Remien RH. Characteristics of HIV antiretroviral treatments, access and adherence in an ethnically diverse sample of men who have sex with men. AIDS Care. 2003;15(1):89–102.CrossRefPubMed

59.

Clark JL, Long CM, Giron JM. Partner notification for sexually transmitted diseases in Peru: knowledge, attitudes, and practices in a high risk community. Sex Transm Dis. 2007;34:309–13.CrossRefPubMed

60.

Bauermesiter JA, Meanley S, Pingel E, et al. PrEP awareness and perceived barriers among single young men who have sex aith men in the United States. Cur HIV Res. 2014;11(7):520–7.CrossRef

61.

Cuevas AG, O’Brien K, Saha S. African American experiences in healthcare: “I always feel like I’m getting skipping over”. Health Psychol. 2016;35(9):987–95.CrossRefPubMed

62.

Boulware LE, Cooper LA, Ratner LE, et al. Race and trust in the health care system. Public Health Rep. 2003;118(4):358–65.CrossRefPubMedPubMedCentral

63.

Sorkin DH, Ngo-Metzger Q, De Alba I. Racial/ethnic discrimination in health care: impact on perceived quality of care. J Gen Intern Med. 2010;25(5):390–6.CrossRefPubMedPubMedCentral

64.

Leibowitz AA, Parker KB, Rotheram-Borus MJ. A US Policy perspective on oral preexposure prophylaxis for HIV. Am J Public Health. 2011;101:982–5.CrossRefPubMedPubMedCentral

65.

Mayer KH, Hosek S, Cohen S, Liu A, Pickett J, Warren M, Krakower D, Grant R. Antiretroviral pre-exposure prophylaxis implementation in the United States: a work in progress. J Int AIDS Soc. 2015;18(4Suppl 3):19980.PubMedPubMedCentral

66.

Centers for Disease control and Prevention. Preexopsure prophylaxis for the prevention of HIV infection in the United Stated—2014: a clinical practice guideline. http://www.cdc.gov/hiv/pdf/guidelines/PrEPguidelines2014.pdf

67.

NYS guidelines: HIV Clinical Resource. New York state guidance for the use of pre-exposure prophylaxis (PrEP) to prevent HIV transmission. 2015. http://www.hivguidelines.org/wp-content/uploads/2016/02/PrEP-Guidance_10-14-15.pdf

68.

Underhill K, Operario D, Mayer KH. Implementation science of pre-exposure prophylaxis: preparing for public use. Curr HIV/AIDS Rep. 2010;7(4):210–9.CrossRefPubMedPubMedCentral

69.

Lewontin RC. Sex, lies and social science. NY Rev Books. 1995;20:24–9.

70.

Desai K, Sansom SL, Ackers ML, et al. Modeling the impact of HIV chemoprophylaxis strategies among men who have sex with men in the United States: HIV infections prevented and cost-effectiveness. Aids. 2008;22(14):1829–39.CrossRefPubMed

71.

Paltiel AD, Freedberg KA, Scott CA, et al. HIV preexposure prophylaxis in the United States: impact on lifetime infection risk, clinical outcomes, and cost effectiveness. Clin Infect Dis. 2009;48(6):806–15.CrossRefPubMedPubMedCentral

72.

Vissers DC, Voeten HA, Nagelkerke NJ, Habbema JD, de Vlas SJ. The impact of pre-exposure prophylaxis (PrEP) on HIV epidemics in Africa and India: a simulation study. PLoS ONE. 2008;3(5):e0277.CrossRef

Title: Awareness and Acceptability of Pre-exposure HIV Prophylaxis Among Men Who have Sex with Men in Baltimore
Authors: Susan A. Fallon
Ju Nyeong Park
Christine Powell Ogbue
Colin Flynn
Danielle German
Publication date: 01-05-2017
Publisher: Springer US
Published in: AIDS and Behavior / Issue 5/2017
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI: https://doi.org/10.1007/s10461-016-1619-z

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Awareness and Acceptability of Pre-exposure HIV Prophylaxis Among Men Who have Sex with Men in Baltimore

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 5/2017

Willingness to Use Pre-Exposure Prophylaxis (PrEP): An Empirical Test of the Information-Motivation-Behavioral Skills (IMB) Model among High-Risk Drug Users in Treatment

Reaching Key Populations: PrEP Uptake in an Urban Health Care System in the Bronx, New York

Minority Men Who Have Sex with Men Demonstrate Increased Risk for HIV Transmission

Impact of Human Resources on Implementing an Evidence-Based HIV Prevention Intervention

Knowledge, Stereotyped Beliefs and Attitudes Around HIV Chemoprophylaxis in Two High HIV Prevalence Neighborhoods in New York City

Affect and Condom Use Among Men Who have Sex with Men: A Daily Diary Study

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page