background: Pre-exposure prophylaxis (PrEP) is highly effective for HIV prevention among people at elevated risk including gay, bisexual, and other men who have sex with men. This study investigates trends in PrEP indicators among men recruited through the CDC-funded National HIV Behavioral Surveillance (NHBS) study in New Orleans in 2011, 2014, and 2017.

methods: Approximately 500 men participated during each NHBS cycle in 2011, 2014, and 2017. Participants were recruited using venue-based time space sampling and completed a structured survey that included measures of PrEP awareness, willingness, and uptake. Bivariate analyses examined predictors of PrEP indicators in each cycle by demographic characteristics. Trends in PrEP indicators over time were examined using Cochran-Armitage Tests.

results: PrEP awareness increased between 2011 (28%), 2014 (51%), and 2017 (90%) indicating a significant positive trend (p<.0001). Similarly, PrEP utilization increased between 2011 (0%), 2014 (2%), and 2017 (26%) (p<.0001). However, while PrEP willingness increased from 2011 (56%) to 2014 (61%), willingness to use PrEP decreased to 45% in 2017.

conclusions: Despite positive trends in PrEP awareness and uptake over time in this population, efforts are needed to improve PrEP use, which remained relatively low. While high awareness (90%) may indicate near saturation in New Orleans, only approximately 1 in 4 participants reported using PrEP in 2017. Additionally, more research is needed to investigate why PrEP willingness has not improved over time. Research exploring factors associated with variations in trends of PrEP awareness, willingness, and uptake are needed to improve the PrEP cascade for this population.