Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Jun 15, 2021
Date Accepted: Oct 28, 2022
Date Submitted to PubMed: Oct 28, 2022
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
PEP as a potential antecedent to PrEP among an online sample of HIV-negative and unknown status cis- and transgender sexual minority men: A cross-sectional study
ABSTRACT
Background:
HIV disproportionately affects sexual minority men (SMM) in the U.S.
Objective:
We sought to determine past HIV post-exposure prophylaxis (PEP) use and current pre-exposure prophylaxis (PrEP) use among an online sample of cisgender and transgender men who have sex with men.
Methods:
In 2019, HIV-negative and unknown status SMM (n=63,015) were recruited via geosocial networking apps, social media, and other online venues to participate in a brief eligibility screening survey. Individuals were asked about past PEP and current PrEP use. We examined associations of demographics, socioeconomic indicators, recent club drug use, and current PrEP use on past PEP use using fully-adjusted logistic regression.
Results:
Prior PEP use was relatively uncommon (11.3%), with 2.66 times more men reporting current PrEP use (30.1%). Most (85.9%) past PEP users were current PrEP users, representing 32.2% of all current PrEP users. In multivariable analysis, current PrEP users had 20.1 times higher odds (95%CI: 18.6-21.6) of past PEP use compared to non-PrEP users. Other factors significantly (p<0.001) associated with past PEP use but with smaller effect sizes included: older age (>24 years old) compared to younger age (AOR=1.15); bisexual identity compared to gay (AOR=0.86); Latino, Black, and other/multiracial race/ethnicity compared to white, individually (AORs=1.37-1.52); having health insurance (AOR=0.80); and recent club drug use (AOR=1.19).
Conclusions:
Prior PEP use was relatively uncommon in our online sample of SMM, but our findings indicate PEP could potentially be a gateway to PrEP. Advertising and prescribing PEP could support efforts to increase PrEP.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.