Awareness and Correlates of HIV Pre-Exposure Prophylaxis (PrEP) Among HIV-negative People Who Access Syringe Services in Seattle, Washington

Abstract

Background

HIV pre-exposure prophylaxis (PrEP) is safe and effective for use in people who inject drugs (PWID), but PrEP is underutilized in this population. We assessed awareness of PrEP and correlates of interest in PrEP among PWID in Seattle, Washington.

Methods

This study analyzed data from a 2019 survey of PWID at 3 Seattle-area syringe service programs (SSPs). We used descriptive statistics to compare PrEP-aware and unaware PWID and multivariable Poisson regression with robust standard errors to estimate adjusted prevalence ratios (APR) for interest in PrEP.

Results

Among 348 HIV-negative PWID, ≤1% were currently taking PrEP, 51% were PrEP aware and 46% were interested in PrEP. Interest in PrEP was inversely associated with prior PrEP awareness (APR 0.58, 95% CI 0.45 − 0.74); however, interest in PrEP was high among PWID meeting pre-specified risk criteria for HIV (APR 1.41, 95% CI 1.06 − 1.88).

Conclusions

Our results suggest increasing awareness of PrEP may not be sufficient to promote PrEP uptake among PWID, and further efforts are needed to understand perceptions of risk for HIV, determinants of PrEP use, and to investigate successful strategies for PrEP implementation and delivery in this marginalized population.

Supplemental data for this article is available online at https://doi.org/10.1080/10826084.2021.2012688 .

Keywords:

• Pre-exposure prophylaxis
• people who inject drugs
• HIV prevention
• syringe service programs

Acknowledgements

Authors would like to acknowledge the SSP clients and staff who participated in and conducted the 2019 PHSKC survey of SSP clients.

Declaration of interest

MAC: Nothing to disclose.

JDS: Has served on a hepatitis B advisory board for Gilead Sciences.

JT: Nothing to disclose.

AW: Nothing to disclose.

SNG: Nothing to disclose.

Additional information

Funding

M.C. was supported in the work by training grants from the National Institute of Diabetes and Digestive and Kidney Diseases [5T32DK007742-22] and the National Institute of Allergy and Infectious Diseases [5T32AI007044-43].