Willingness to Use Oral and Long-Acting Injectable PrEP in Substance-Using Men who have Sex with Men (SU-MSM) in High HIV Incidence Southern U.S. Cities: A NIDA Clinical Trials Network Study

Susan Tross; Tanja C Laschober; Margaret Paschen-Wolff; Melissa Ertl; C Mindy Nelson; Lynette Wright; Chloe Lancaster; Daniel J Feaster; Mauda Monger; Phil Toal; Joshua P Fegley; David Meche; Colby Hankey; Christina Woodhouse; Anya Spector; Lauren Dresser; Landhing Moran; Eve Jelstrom; Louise Haynes; Steven Shoptaw; Mary A Hatch

doi:10.1007/s10461-024-04594-7

Willingness to Use Oral and Long-Acting Injectable PrEP in Substance-Using Men who have Sex with Men (SU-MSM) in High HIV Incidence Southern U.S. Cities: A NIDA Clinical Trials Network Study

AIDS Behav. 2024 Dec 30. doi: 10.1007/s10461-024-04594-7. Online ahead of print.

Authors

Susan Tross¹, Tanja C Laschober², Margaret Paschen-Wolff³, Melissa Ertl⁴, C Mindy Nelson⁵, Lynette Wright², Chloe Lancaster⁶, Daniel J Feaster⁵, Mauda Monger^{7

8}, Phil Toal⁹, Joshua P Fegley^{10

11}, David Meche^{12

13}, Colby Hankey⁹, Christina Woodhouse¹⁴, Anya Spector¹⁵, Lauren Dresser¹⁶, Landhing Moran¹⁷, Eve Jelstrom¹⁶, Louise Haynes¹⁸, Steven Shoptaw¹⁹, Mary A Hatch²

Affiliations

¹ Columbia University Irving Medical Center, New York, NY, USA. [email protected].
² University of Washington Addictions, Drug & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, Seattle, WA, USA.
³ Columbia University Irving Medical Center, New York, NY, USA.
⁴ Present address: Department of Psychology, University of Minnesota, Minneapolis, MN, USA.
⁵ Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
⁶ Department of Leadership, Policy, and Lifelong Learning, University of South Florida, Tampa, FL, USA.
⁷ My Brother's Keeper, Ridgeland, MS, USA.
⁸ Present address: Myrlie Evers-Williams Institute for the Elimination of Health Disparities, Center for HIV/AIDS Research, Education and Policy, University of Mississippi Medical Center, Jackson, MS, USA.
⁹ Aspire Health Partners, HIV Services, Orlando, FL, USA.
¹⁰ Crescent Care, New Orleans, LA, USA.
¹¹ Present address: Tulane School of Social Work, New Orleans, LA, USA.
¹² Open Health Care Clinic, Baton Rouge, LA, USA.
¹³ Present address: School of Social Work, Louisiana State University, Baton Rouge, LA, USA.
¹⁴ Jasmyn, Jacksonville, FL, USA.
¹⁵ Stella and Charles Guttman Community College, City University of New York, New York, NY, USA.
¹⁶ The Emmes Company, LLC, Rockville, MD, USA.
¹⁷ Center for the Clinical Trials Network, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA.
¹⁸ Medical University of South Carolina, Charleston, SC, USA.
¹⁹ University of California at Los Angeles, Los Angeles, CA, USA.

PMID: 39739284
DOI: 10.1007/s10461-024-04594-7

Abstract

In Southern U.S. states with high HIV incidence and low HIV Pre-Exposure Prophylaxis (PrEP) uptake, enhanced efforts to increase interest in and willingness to use PrEP are needed. This implementation survey examined the associations of sociodemographic background, substance use, and sexual risk behaviors with willingness to use daily oral and long-acting injectable (LAI) PrEP among substance using men who have sex with men (SU-MSM). Participants were 225 SU-MSM recruited from sexually transmitted infection (STI) clinics, syringe services programs (SSPs), and substance use treatment programs (SUTPs) in eight Southern U.S. cities. Rates of willingness were high for both daily oral PrEP (78%) and LAI PrEP (66%). In multivariable analyses, distinct factors were associated with willingness towards each. For daily oral PrEP, greater willingness was associated with condomless anal sex, less frequent non-injection opioid use, prior PrEP awareness, and past use of PrEP. For LAI PrEP, greater willingness was associated with Black race, identifying as gay, being single, and higher injection drug use frequency. Lower willingness to use LAI PrEP was associated with higher non-injection opioid use frequency. Findings about willingness to use LAI PrEP, as a relatively newer modality, and greater willingness among Black SU-MSM as a disproportionately HIV-impacted population, are especially important. These findings argue for the necessity to enhance PrEP promotion efforts that distinguish between oral and LAI PrEP and that are specifically tailored to major SU-MSM subgroups in the Southern U.S.

Keywords: HIV risk; MSM; PrEP; Southern United States; Substance use.

Abstract

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