Despite Increasing PrEP Awareness, Use Remains Low for People at High Risk of HIV

Beliefs about health care and negative experiences with the medical system may influence the use of pre-exposure prophylaxis (PrEP) among patients with HIV, according to investigators at Rutgers University.

Cisgender sexual minority men and transgender women are considered at high risk for HIV, and although the researchers found that they are aware of PrEP, very few are currently taking it. In a study published in AIDS and Behavior, the investigators surveyed 202 young sexual minority men and transgender women to better understand why some are more likely than others to take PrEP.

According to the study, sexual minority men are the community most impacted by HIV, with 69% of all new diagnoses in 2018. Similarly, transgender populations are disproportionately impacted by HIV and its accompanying prevention challenges. Although Black and Latinx populations are most likely to be newly diagnosed with HIV, however, officials with the CDC have said that PrEP users are more likely to be white.

In the new study, despite the fact that 98% of the survey respondents said they were aware of PrEP, less than 25% were currently taking it.

“It was surprising that so few participants were using PrEP, but we were happy to see that there were no racial or ethnic disparities in who was using it,” said study coauthor Caleb LoSchiavo, a doctoral candidate at the Rutgers School of Public Health, in the press release. “I think the study results point to the effectiveness of local efforts to increase the use of PrEP for those who need it most.”

Although the researchers found unexpected equity in PrEP use, they also found racial and ethnic differences in factors associated with its use. For example, white participants’ likelihood of using PrEP was found to increase with age and decrease if they reported concerns about daily medication use. Participants of color were found more likely to take PrEP if they received information about it from a health care provider and if they had more positive beliefs about its use.

“Our study highlights the importance of clinicians in expanding the use of HIV prevention methods like PrEP among those who need it most, both through informing their patients about PrEP and through combating stigmatizing beliefs about PrEP use,” said senior study author Perry N. Halkitis, PhD, MS, MPH, dean of the Rutgers School of Public Health, in the press release.

The findings illustrate the important role clinicians can play in educating patients about PrEP and HIV prevention, the authors said. Pharmacists can play an especially important role in communities of color by considering historical contexts and social determinants of health.

“Positive public health messaging about PrEP must reframe risk, combat stigma, and normalize preventive health care,” LoSchiavo concluded in the press release.

REFERENCE

People at High Risk for HIV Know About Prevention Pill, But Use Remains Low [news release]. Rutgers University; April 21, 2021. https://www.rutgers.edu/news/people-high-risk-hiv-know-about-prevention-pill-use-remains-low. Accessed April 22, 2021.