Social determinants of self-reported pre-exposure prophylaxis use among a national sample of US men who have sex with men

Sex Transm Infect. 2020 Aug;96(5):368-374. doi: 10.1136/sextrans-2019-054177. Epub 2019 Oct 10.

Abstract

Purpose: Various disparities exist in HIV transmission among men who have sex with men (MSM). Pre-exposure prophylaxis (PrEP) has been shown to decrease the acquisition of HIV, but there is variation in uptake within the MSM population. We aim to characterise PrEP use and correlates of self-reported PrEP use in a large national sample of urban MSM in the USA.

Methods: Using data from a geosocial-networking application, a national sample (n=3744) from the largest 50 metropolitan centres in the USA was obtained.

Results: We found 18.1% (95% CI 16.8 to 19.3) of profiles reported using PrEP, with decreased reported PrEP use in younger MSM aged 18-24 years (adjusted OR (aOR)=0.5, 95% CI 0.3 to 0.7), obese MSM (aOR=0.5, 95% CI 0.3 to 0.9), black MSM (aOR=0.6, 95% CI 0.4 to 0.9) and MSM in the South (aOR=0.7, 95% CI 0.5 to 0.9).

Conclusion: Significant disparities exist in PrEP reporting by age and among black, Southern US and obese MSM. More research is needed to better understand these disparities.

Keywords: HIV; HIV pre-exposure prophylaxis; PrEP; gay men; men.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Anti-HIV Agents / therapeutic use*
  • Asian / statistics & numerical data
  • Black or African American / statistics & numerical data
  • Ethnicity / statistics & numerical data*
  • HIV Infections / prevention & control*
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Obesity / epidemiology*
  • Odds Ratio
  • Overweight / epidemiology
  • Pre-Exposure Prophylaxis / statistics & numerical data*
  • Self Report
  • Sexual and Gender Minorities / statistics & numerical data*
  • Social Determinants of Health
  • Southeastern United States / epidemiology
  • United States / epidemiology
  • White People / statistics & numerical data
  • Young Adult

Substances

  • Anti-HIV Agents