Impact of an educational video on knowledge of non-occupational post-exposure prophylaxis for HIV prevention among a high-risk New York City population: The iPEPcare study

Background: Knowledge of post-exposure prophylaxis (PEP) for non-occupational HIV exposures is low among high-risk populations, with the exception of MSM. We investigated the impact of an educational video on PEP knowledge among a vulnerable, low-income population in New York City.

Methods: Targeted street outreach, word-of-mouth, and pharmacy recruitment of syringe customers who inject drugs were used to recruit individuals from high drug use neighborhoods into a pilot intervention that aimed to increase PEP knowledge (n=483). Participants watched an educational PEP video and completed pre/post-video surveys to assess PEP knowledge. PEP knowledge included knowing that PEP a) must be initiated within 72 hours of an exposure and taken for 28 days, b) requires monitoring with a doctor, and d) is not 100% effective.  McNemar’s test was used to identify changes in PEP knowledge; logistic and log-binomial regression were used to determine correlates of 1) pre-video, and 2) post-video PEP knowledge.

Results: Most participants were Black or Latino (83.7%), and reported using illicit drugs (58.8%). Pre-video, Latinos were less likely than whites to be PEP knowledgeable (AOR: 0.24; 95% CI: 0.11-0.56).  PEP knowledge significantly increased post-video (pre-video: 9.8% vs. post-video: 79.3%). After adjustment, those who were PEP knowledgeable, post-video, had higher educational attainment (APR: 1.17; 95% CI:1.04-1.31), lower incomes (APR: 0.87; 95% CI:0.77-0.98) and lower external HIV stigma (APR: 0.94; 95% CI: 0.91-0.98).

Conclusions: The use of an educational video may be effective in increasing PEP knowledge in marginalized populations. Interventions aimed at increasing PEP knowledge should also consider targeting HIV stigma.