141st APHA Annual Meeting

In This section

288463
Concerns regarding PrEP accessibility and affordability among YMSM in the United States

Wednesday, November 6, 2013 : 12:45 PM - 1:00 PM

Jose A. Bauermeister, MPH, PhD , Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI
Emily Pingel, MPH , Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI
Steven Meanley , Sexuality & Health Lab (SexLab), University of Michigan School of Public Health, Ann Arbor, MI
Laura Jadwin-Cakmak, MPH , Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI
Gary W. Harper, PhD, MPH , Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI
Pre-exposure prophylaxis (PrEP) has the potential to help reduce new HIV/AIDS infections among young men who have sex with men (YMSM); however, PrEP's accessibility and affordability remains questionable. Using a cross-sectional survey of YMSM (N=1,507; ages 18-24; 65% White, 9% Black, 17% Latino, 9% Other race/ethnicity), we gauged YMSM's PrEP awareness and PrEP-related beliefs regarding accessibility and affordability. Overall, 27% of the sample had heard about PrEP; 1% reported ever using PrEP prior to sex. In a multivariate logistic regression, we found that YMSM were more likely to have heard about PrEP if they were older (OR=1.12), more educated (OR=1.20), had insurance (OR=1.47), and reported at least one sexually-acquired infection (STI) in their lifetime (OR=1.81). We noted no differences by sexual risk behavior or race/ethnicity. Once a description of PrEP was offered to survey participants, two thirds of the sample (64.4%) noted that they would not know where to acquire PrEP, nor believed that they would able to afford it (62.4%). In multivariate linear regression models, YMSM's belief of PrEP accessibility was associated with insurance (b=.24), identifying as Latino (b=.23) or Asian (b=.42), and having heard about PrEP in the past (b=.40). PrEP affordability belief was associated with insurance (b=-.44) and a prior STI (b=.21). Black (b=-.28), Asian (b=-.07), or Other Race/Ethnicity (b=-.52) YMSM were less likely than Whites to report PrEP affordability belief. PrEP rollout may be hindered due to awareness, accessibility and affordability barriers. We propose strategies to maximize equity in PrEP awareness, access and use among YMSM.

Learning Areas:
Planning of health education strategies, interventions, and programs
Program planning
Public health or related education
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Identify how structural conditions may hinder the optimal rollout of PrEP among YMSM in the United States. Assess how sociodemographic characteristics may be associated with YMSM’s PrEP awareness and accessibility and affordability beliefs. Consider multilevel strategies that maximize equity in access and use among YMSM interested in considering PrEP as a prevention strategy.

Keywords: HIV/AIDS, Barriers to Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: My research focuses on HIV/AIDS prevention among young men who have sex with men
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5173.0: PrEP and HIV prevention