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Published in: Journal of Urban Health 6/2019

01-12-2019 | Care

The Pre-exposure Prophylaxis (PrEP) Continuum of Care and Correlates to Initiation Among HIV-Negative Men Recruited at Miami Gay Pride 2018

Authors: Angel B. Algarin, Cho Hee Shrader, Chintan Bhatt, Benjamin T. Hackworth, Robert L. Cook, Gladys E. Ibañez

Published in: Journal of Urban Health | Issue 6/2019

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Abstract

While the national HIV infection rate is decreasing, the highest rates of infections continue among men who have sex with men (MSM), particularly minority MSM. It is important to understand attitudes, knowledge, and behaviors surrounding HIV prevention methods, such as pre-exposure prophylaxis (PrEP). In the present study, we created a snapshot of the PrEP continuum of care and identified participant demographic and sources of PrEP awareness factors that were associated with PrEP initiation. Data were collected using anonymous paper–based surveys employing a venue intercept procedure. A total of 188 HIV–negative men completed the survey at Miami Gay Pride 2018. Participants answered questions regarding demographics, PrEP use, and sources of PrEP awareness. The sample was majority Hispanic (55.4%), gay (83.0%), and single (57.7%). The constructed PrEP continuum revealed that a low proportion of those identified as PrEP naïve (n = 143) for HIV infection had PrEP interest (49/143). Moreover, among those who initiated PrEP (n = 45), a high proportion were retained in a PrEP program (37/45), with approximately half achieving medication adherence (25/45). Age group, PrEP knowledge, and source of PrEP awareness were all significantly associated with PrEP initiation. In areas with high HIV infection rates, studies like these offer crucial insight on how public health practitioners should proceed in the goal of decreasing HIV transmission rates. More research is needed to increase PrEP uptake and adherence.
Literature
4.
go back to reference Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, Vargas L, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–99.CrossRef Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, Vargas L, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–99.CrossRef
5.
go back to reference McCormack S, Dunn DT, Desai M, Dolling DI, Gafos M, Gilson R, et al. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet. 2016;387(10013):53–60.CrossRef McCormack S, Dunn DT, Desai M, Dolling DI, Gafos M, Gilson R, et al. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet. 2016;387(10013):53–60.CrossRef
9.
go back to reference Sullivan PS, Carballo-Diéguez A, Coates T, Goodreau SM, McGowan I, Sanders EJ, et al. Successes and challenges of HIV prevention in men who have sex with men. Lancet. 2012;380(9839):388–99.CrossRef Sullivan PS, Carballo-Diéguez A, Coates T, Goodreau SM, McGowan I, Sanders EJ, et al. Successes and challenges of HIV prevention in men who have sex with men. Lancet. 2012;380(9839):388–99.CrossRef
11.
go back to reference Kelley CF, Kahle E, Siegler A, Sanchez T, del Rio C, Sullivan PS, et al. Applying a PrEP continuum of care for men who have sex with men in Atlanta, Georgia. Clin Infect Dis. 2015;61(10):1590–7.CrossRef Kelley CF, Kahle E, Siegler A, Sanchez T, del Rio C, Sullivan PS, et al. Applying a PrEP continuum of care for men who have sex with men in Atlanta, Georgia. Clin Infect Dis. 2015;61(10):1590–7.CrossRef
12.
go back to reference Nunn AS, Brinkley-Rubinstein L, Oldenburg CE, Mayer KH, Mimiaga M, Patel R, et al. Defining the HIV pre-exposure prophylaxis care continuum. AIDS. 2017;31(5):731–4.CrossRef Nunn AS, Brinkley-Rubinstein L, Oldenburg CE, Mayer KH, Mimiaga M, Patel R, et al. Defining the HIV pre-exposure prophylaxis care continuum. AIDS. 2017;31(5):731–4.CrossRef
14.
go back to reference Hood JE, Buskin SE, Dombrowski JC, Kern DA, Barash EA, Katz DA, et al. Dramatic increase in preexposure prophylaxis use among MSM in Washington state. AIDS. 2016;30(3):515–9.PubMed Hood JE, Buskin SE, Dombrowski JC, Kern DA, Barash EA, Katz DA, et al. Dramatic increase in preexposure prophylaxis use among MSM in Washington state. AIDS. 2016;30(3):515–9.PubMed
15.
go back to reference Bauermeister JA, Meanley S, Pingel E, Soler JH, Harper GW. PrEP awareness and perceived barriers among single young men who have sex with men in the United States. Curr HIV Res. 2013;11(7):520.CrossRef Bauermeister JA, Meanley S, Pingel E, Soler JH, Harper GW. PrEP awareness and perceived barriers among single young men who have sex with men in the United States. Curr HIV Res. 2013;11(7):520.CrossRef
16.
go back to reference Dolezal C, Frasca T, Giguere R, Ibitoye M, Cranston RD, Febo I, et al. Awareness of post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) is low but interest is high among men engaging in condomless anal sex with men in Boston, Pittsburgh, and San Juan. AIDS Educ Prev. 2015;27(4):289–97.CrossRef Dolezal C, Frasca T, Giguere R, Ibitoye M, Cranston RD, Febo I, et al. Awareness of post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) is low but interest is high among men engaging in condomless anal sex with men in Boston, Pittsburgh, and San Juan. AIDS Educ Prev. 2015;27(4):289–97.CrossRef
17.
go back to reference Snowden JM, Chen Y, McFarland W, et al. Prevalence and characteristics of users of pre-exposure prophylaxis (PrEP) among men who have sex with men, San Francisco, 2014 in a cross-sectional survey: implications for disparities. Sex Transm Infect. 2017;93(1):52–5.CrossRef Snowden JM, Chen Y, McFarland W, et al. Prevalence and characteristics of users of pre-exposure prophylaxis (PrEP) among men who have sex with men, San Francisco, 2014 in a cross-sectional survey: implications for disparities. Sex Transm Infect. 2017;93(1):52–5.CrossRef
18.
go back to reference Cohen SE, Vittinghoff E, Bacon O, Doblecki-Lewis S, Postle BS, Feaster DJ, et al. High interest in pre-exposure prophylaxis among men who have sex with men at risk for HIV-infection: baseline data from the US PrEP demonstration project. J Acquir Immune Defic Syndr. 2015;68(4):439–48.CrossRef Cohen SE, Vittinghoff E, Bacon O, Doblecki-Lewis S, Postle BS, Feaster DJ, et al. High interest in pre-exposure prophylaxis among men who have sex with men at risk for HIV-infection: baseline data from the US PrEP demonstration project. J Acquir Immune Defic Syndr. 2015;68(4):439–48.CrossRef
19.
go back to reference Landovitz RJ, Tseng C, Weissman M, et al. Epidemiology, sexual risk behavior, and HIV prevention practices of men who have sex with men using GRINDR in Los Angeles, California. J Urban Health. 2013;90(4):729–39.CrossRef Landovitz RJ, Tseng C, Weissman M, et al. Epidemiology, sexual risk behavior, and HIV prevention practices of men who have sex with men using GRINDR in Los Angeles, California. J Urban Health. 2013;90(4):729–39.CrossRef
20.
go back to reference Mayer KH, Oldenburg CE, Novak DS, Elsesser SA, Krakower DS, Mimiaga MJ. Early adopters: correlates of HIV chemoprophylaxis use in recent online samples of US men who have sex with men. AIDS Behav. 2016;20(7):1489–98.CrossRef Mayer KH, Oldenburg CE, Novak DS, Elsesser SA, Krakower DS, Mimiaga MJ. Early adopters: correlates of HIV chemoprophylaxis use in recent online samples of US men who have sex with men. AIDS Behav. 2016;20(7):1489–98.CrossRef
21.
go back to reference Holloway IW, Dougherty R, Gildner J, Beougher SC, Pulsipher C, Montoya JA, et al. Brief report: PrEP uptake, adherence, and discontinuation among California YMSM using geosocial networking applications. J Acquir Immune Defic Syndr. 2017;74(1):15–20.CrossRef Holloway IW, Dougherty R, Gildner J, Beougher SC, Pulsipher C, Montoya JA, et al. Brief report: PrEP uptake, adherence, and discontinuation among California YMSM using geosocial networking applications. J Acquir Immune Defic Syndr. 2017;74(1):15–20.CrossRef
22.
go back to reference Grant RM, Anderson PL, McMahan V, Liu A, Amico KR, Mehrotra M, et al. Uptake of pre-exposure prophylaxis, sexual practices, and HIV incidence in men and transgender women who have sex with men: a cohort study. Lancet Infect Dis. 2014;14(9):820–9.CrossRef Grant RM, Anderson PL, McMahan V, Liu A, Amico KR, Mehrotra M, et al. Uptake of pre-exposure prophylaxis, sexual practices, and HIV incidence in men and transgender women who have sex with men: a cohort study. Lancet Infect Dis. 2014;14(9):820–9.CrossRef
23.
go back to reference Krakower DS, Mimiaga MJ, Rosenberger JG, Novak DS, Mitty JA, White JM, et al. Limited awareness and low immediate uptake of pre-exposure prophylaxis. PLoS One. 2012;7(3):e33119.CrossRef Krakower DS, Mimiaga MJ, Rosenberger JG, Novak DS, Mitty JA, White JM, et al. Limited awareness and low immediate uptake of pre-exposure prophylaxis. PLoS One. 2012;7(3):e33119.CrossRef
24.
go back to reference 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.CrossRef 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.CrossRef
25.
go back to reference Pérez-Figueroa RE, Kapadia F, Barton SC, Eddy JA, Halkitis PN. Acceptability of PrEP uptake among racially/ethnically diverse young men who have sex with men: the P18 study. AIDS Educ Prev. 2015;27(2):112–25.CrossRef Pérez-Figueroa RE, Kapadia F, Barton SC, Eddy JA, Halkitis PN. Acceptability of PrEP uptake among racially/ethnically diverse young men who have sex with men: the P18 study. AIDS Educ Prev. 2015;27(2):112–25.CrossRef
26.
go back to reference Eaton LA, Kalichman SC, Price D, Finneran S, Allen A, Maksut J. Stigma and conspiracy beliefs related to pre-exposure prophylaxis (PrEP) and interest in using PrEP among Black and White men and transgender women who have sex with men. AIDS Behav. 2017;21(5):1236–46.CrossRef Eaton LA, Kalichman SC, Price D, Finneran S, Allen A, Maksut J. Stigma and conspiracy beliefs related to pre-exposure prophylaxis (PrEP) and interest in using PrEP among Black and White men and transgender women who have sex with men. AIDS Behav. 2017;21(5):1236–46.CrossRef
27.
go back to reference Crawford JM, Rodden P, Kippax S, van de Ven P. Negotiated safety and other agreements between men in relationships: risk practice redefined. Int J STD AIDS. 2001;12(3):164–70.CrossRef Crawford JM, Rodden P, Kippax S, van de Ven P. Negotiated safety and other agreements between men in relationships: risk practice redefined. Int J STD AIDS. 2001;12(3):164–70.CrossRef
28.
go back to reference Hoff CC, Beougher SC, Chakravarty D, Darbes LA, Neilands TB. Relationship characteristics and motivations behind agreements among gay male couples: differences by agreement type and couple serostatus. AIDS Care. 2010;22(7):827–35.CrossRef Hoff CC, Beougher SC, Chakravarty D, Darbes LA, Neilands TB. Relationship characteristics and motivations behind agreements among gay male couples: differences by agreement type and couple serostatus. AIDS Care. 2010;22(7):827–35.CrossRef
29.
go back to reference Mitchell JW, Harvey SM, Champeau D, Seal DW. Relationship factors associated with HIV risk among a sample of gay male couples. AIDS Behav. 2012;16(2):404–11.CrossRef Mitchell JW, Harvey SM, Champeau D, Seal DW. Relationship factors associated with HIV risk among a sample of gay male couples. AIDS Behav. 2012;16(2):404–11.CrossRef
31.
go back to reference Chan PA, Mena L, Patel R, Oldenburg CE, Beauchamps L, Perez-Brumer AG, Parker S, Mayer KH, Mimiaga MJ, Nunn A Retention in care outcomes for HIV pre-exposure prophylaxis implementation programmes among men who have sex with men in three US cities. J Int AIDS Soc 2016; 19(1)CrossRef Chan PA, Mena L, Patel R, Oldenburg CE, Beauchamps L, Perez-Brumer AG, Parker S, Mayer KH, Mimiaga MJ, Nunn A Retention in care outcomes for HIV pre-exposure prophylaxis implementation programmes among men who have sex with men in three US cities. J Int AIDS Soc 2016; 19(1)CrossRef
33.
go back to reference Landry J. Delivering culturally sensitive care to LGBTQI patients. J Nurse Pract. 2017;13(5):342–7.CrossRef Landry J. Delivering culturally sensitive care to LGBTQI patients. J Nurse Pract. 2017;13(5):342–7.CrossRef
34.
go back to reference Liu A, Cohen S, Follansbee S, Cohan D, Weber S, Sachdev D, et al. Early experiences implementing pre-exposure prophylaxis (PrEP) for HIV prevention in San Francisco. PLoS Med. 2014;11(3):e1001613.CrossRef Liu A, Cohen S, Follansbee S, Cohan D, Weber S, Sachdev D, et al. Early experiences implementing pre-exposure prophylaxis (PrEP) for HIV prevention in San Francisco. PLoS Med. 2014;11(3):e1001613.CrossRef
35.
go back to reference Saberi P, Berrean B, Thomas S, Gandhi M, Scott H. A simple pre-exposure prophylaxis (PrEP) optimization intervention for health care providers prescribing PrEP: pilot study. JMIR Formative Research. 2018;2(1):e2.https://formative.jmir.org/ CrossRef Saberi P, Berrean B, Thomas S, Gandhi M, Scott H. A simple pre-exposure prophylaxis (PrEP) optimization intervention for health care providers prescribing PrEP: pilot study. JMIR Formative Research. 2018;2(1):e2.https://​formative.​jmir.​org/​ CrossRef
Metadata
Title
The Pre-exposure Prophylaxis (PrEP) Continuum of Care and Correlates to Initiation Among HIV-Negative Men Recruited at Miami Gay Pride 2018
Authors
Angel B. Algarin
Cho Hee Shrader
Chintan Bhatt
Benjamin T. Hackworth
Robert L. Cook
Gladys E. Ibañez
Publication date
01-12-2019
Publisher
Springer US
Published in
Journal of Urban Health / Issue 6/2019
Print ISSN: 1099-3460
Electronic ISSN: 1468-2869
DOI
https://doi.org/10.1007/s11524-019-00362-4

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