PrEP Use Has Increased, But Rate Still Too Low

PrEP Use Has Increased, But Rate Still Too Low

September 15, 2019 330

A recent study has found that while awareness and use of pre-exposure prophylaxis drugs have increased in almost all demographic subgroups, only approximately 1 in 3 of men who have sex with men (MSM) use the HIV-prevention drug.1

Increasing PrEP use has become a cornerstone of the US Department of Health and Human Service's "Ending the HIV Epidemic" initiative, which has set the goal of a 75% reduction in new HIV infections within 5 years, and reducing new HIV infections by at least 90% within 10 years.2

PrEP awareness, at least, has increased according to the study. From 2014 to 2017, the study found that PrEP awareness increased from 60% to 90% among MSM in 20 urban areas. In the same time frame, the researchers found that PrEP use increased from 6% to 35%.1

These numbers increased among almost all demographic subgroups, but use among black and Hispanic MSM remains low, according to the study. The CDC urged continued efforts to improve coverage and to connect black and Hispanic MSM to health care providers in order to bridge this gap.

In the study, staff members from the CDC’s National HIV Behavioral Surveillance (NHBS) collected cross-sectional behavioral survey data in 20 urban areas and conducted HIV testing among MSM at recruitment events using venue-based sampling. The analysis was limited to MSM who had a negative NHBS HIV test result, did not report a previous HIV-positive test result, had either one male sex partner who was HIV-positive or 2 or more male sex partners in the past 12 months, and reported either condomless anal sex or a bacterial STI in the past 12 months.1

While the study was conducted in 2014 and 2017, PrEP awareness and use were measured differently. The 2014 question asked whether patients “had ever heard of people who do not have HIV taking anti-HIV medicines, to keep from getting HIV,” and whether in the past 12 months they had “taken anti-HIV medicines before sex because you thought it would keep you from getting HIV.” In 2017, survey participants were given more information about PrEP and its uses, before being asked if they knew anyone who had taken it or if they themselves had taken it in the last 12 months.1

The 2017 survey had several relevant findings in the demographics of PrEP awareness and use:1

  • Over 80% of MSM in 17 of 20 urban areas and in most demographic subgroups were aware of PrEP.
  • Compared to 2014, substantial increases in PrEP use occurred among black, Hispanic, and MSM aged 18-29 years.
  • The differences in PrEP use between Hispanic and white MSM, and between young and older MSM, were no longer significant after controlling for income, health insurance, and region.
  • The difference in reported PrEP use between black and white MSM remained significant after controlling for income, health insurance, and region.
  • PrEP use increased with education and income.
  • Finally, 39% of the MSM who saw a health care provider in the past 12 months reported PrEP use.


While the increase in PrEP awareness and use is encouraging, the CDC urged increased coverage of the drug, especially among black and Hispanic MSM. Health care providers can play a critical role, the researchers concluded, by routinely testing their patients for HIV, assessing HIV-negative patients for risk behaviors, and prescribing PrEP as needed.1


References

  1. Centers for Disease Control and Prevention. Changes in HIV Preexposure Prophylaxis Awareness and Use Among Men Who Have Sex with Men - 20 Urban Areas, 2014 and 2017 | MMWR. CDC website. https://www.cdc.gov/mmwr/volumes/68/wr/mm6827a1.htm. Published July 12, 2019. Accessed September 10, 2019.
  2. What is 'Ending the HIV Epidemic: A Plan for America'? HIV.gov. https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/overview. Accessed September 10, 2019.

 

 

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