Limited awareness of pre-exposure prophylaxis among black men who have sex with men and transgender women in New York city

ABSTRACT

Awareness of Pre-exposure prophylaxis (PrEP) was assessed among a cohort of substance-using black men who have sex with men and transgender women (MSM/TGW) participating in the STAR Study, which recruited black MSM/TGW in New York City for HIV testing and linked HIV-infected individuals into care from July 2012 to April 2015. Sociodemographic, psychosocial, known HIV risk factors, and PrEP awareness were assessed among participants. Multivariable logistic regression was conducted to assess factors associated with PrEP awareness. Of 1673 participants, median age was 43 years and 25% were under age 30. Most participants (85.8%) reported having insufficient income for basic necessities at least occasionally, 54.8% were homeless, and 71.3% were unemployed. Awareness of PrEP was reported among 18.2% of participants. PrEP awareness was associated with younger age (adjusted odds ratio [aOR] 0.87, per 5 years), gay identity (aOR 2.46), higher education (aOR 1.70), more frequent past HIV testing (aOR 3.18), less HIV stigma (aOR 0.61), less hazardous/harmful alcohol use (aOR 0.61), and more sexual partners (aOR 1.04, per additional partner in past 30 days). In this substance-using black MSM/TGW cohort with high rates of poverty and homelessness, PrEP awareness was low. This study demonstrates the need for targeted dissemination of PrEP information to key populations to increase awareness and ultimately improve uptake and utilization of PrEP.

KEYWORDS:

• HIV prevention
• pre-exposure prophylaxis (PrEP)
• men who have sex with men (MSM)
• transgender women (TGW)

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Matthew Garnett http://orcid.org/0000-0002-1867-6856

Yael Hirsch-Moverman http://orcid.org/0000-0003-0096-1306

Julie Franks http://orcid.org/0000-0001-6329-2301

Wafaa M. El-Sadr http://orcid.org/0000-0003-3735-9781

Additional information

Funding

This research was supported by the National Institute on Drug Abuse: “Seek, Test, and Retain: Linkages for Black HIV+, Substance Using MSM” under [grant number R01DA032100].