Structural and behavioral factors associated with intentions to begin HIV pre-exposure prophylaxis (PrEP) among gay and bisexual men in the United States
Method: We conducted a 6-month follow-up survey on PrEP willingness and intentions among 802 HIV-negative GBM in the nationally representative One Thousand Strong panel.
Results: Although 458 (56.5%) were willing to take PrEP, only 131 (16.2%) intended to; among those, 58.0% intended to do so within three months. PrEP intentions were highest among men who were: Black (29.3%) or multiracial (25.4%), p=.008; from the South (19.6%), p=.01; high school graduates or less (34.5%), p<.001; making less than $20,000/year (23.2%), p<.001; single (20.3%), p<.001; and having condomless anal sex (23.8%), p<.001. Being insured, having a primary care doctor, and local population density were not significantly associated with PrEP intentions. In a multivariable model, younger age, Black (versus White) race/ethnicity, lower education, being single, and having engaged in HIV risk independently predicted PrEP intentions (all p<.05).
Conclusions: These findings demonstrate that more Black/multiracial GBM have intentions to begin PrEP compared to White and Latino men, but highlight the role that lower socioeconomic position and geographic region may play in limiting access to care. Structural-level approaches such as PrEP drug assistance programs are needed to equitably distribute PrEP to GBM who desire it.
Learning Areas:Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related public policy
Social and behavioral sciences
Differentiate those groups with higher versus lower intentions to begin a PrEP regimen Identify a structural-level program that may help improve access for these groups
Keyword(s): Prevention, Lesbian, Gay, Bisexual and Transgender (LGBT)
Qualified on the content I am responsible for because: I have been conducting research in the field of HIV prevention for more than 9 years. I hold an MPH in Biostatistics and a PhD in Psychology. I am currently a Research Scientist and the Senior Data Analyst at Hunter College's Center for HIV Educational Studies & Training (CHEST) as well as an Adjunct Assistant Professor at the CUNY School of Public Health.
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.