Milken Institute School of Public Health Poster Presentations (Marvin Center & Video)

Title

Perceived risk of HIV, PrEP eligibility, and PrEP use among young men who have sex with men in Washington, DC

Poster Number

71

Document Type

Poster

Status

Staff

Abstract Category

Epidemiology and Biostatistics

Keywords

Perceived HIV risk, Pre-exposure prophylaxis, Young men who have sex with men

Publication Date

Spring 2018

Abstract

Background In 2014, the CDC issued guidelines recommending pre-exposure prophylaxis (PrEP) for people at high risk of HIV infection. Recent studies indicate that low HIV risk perception may be a barrier to PrEP use among high-risk men who have sex with men (MSM). With efforts to increase awareness and uptake of PrEP, this analysis aimed to examine relationships between HIV risk perception, PrEP eligibility, and PrEP use specifically among young MSM, who accounted for an estimated 22% of new HIV diagnoses in 2015. Methods We analyzed cross-sectional survey data collected from MSM ages 16-25 in the Washington, DC metro area. The Perceived Risk of HIV Scale, a validated eight-item Likert scale, was adapted to measure risk perception (low or moderate/high). PrEP eligibility was determined using the MSM Risk Index, a six-item sexual risk behavior tool included in the 2014 CDC Clinical Providers’ Supplement. Participants reported their willingness to use PrEP and whether they currently used PrEP. Chi-square and Fisher's exact tests were used to assess differences in PrEP eligibility by risk perception categories. Adjusted odds ratios (aOR) were calculated using multivariable logistic regression to evaluate the associations between risk perception and PrEP willingness and use among PrEP-eligible participants. Results Of 188 participants with self-reported HIV-negative or HIV-unknown status, 149 (79.3%) had moderate/high perceived risk and 115 (61.2%) met index criteria for PrEP eligibility. A higher proportion of PrEP-eligible participants had moderate/high risk perception compared to those not considered eligible (86.1% vs. 68.5%, p=0.004). Among participants who were PrEP-eligible, 75.7% reported that they were willing to use PrEP. PrEP-eligible participants with moderate/high perceived risk had greater odds of willingness to take PrEP compared to those with low perceived risk (aOR 4.3, 95% CI: 1.4-13.8). Current PrEP use was reported by only 9.6% of PrEP-eligible participants and was not significantly associated with risk perception (aOR 1.7, 95% CI: 0.2-14.1). Conclusion HIV risk perception and willingness to use PrEP were both high among young MSM who met criteria for PrEP eligibility, yet few of these participants reported currently taking PrEP. Those who perceived their risk of HIV infection to be moderate or high were significantly more likely to be willing to take PrEP. These findings suggest the importance of risk perception as a correlate of PrEP acceptance and indicate that public health interventions to increase PrEP uptake may benefit from the inclusion of risk-related messaging tailored specifically to the young MSM population.

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Perceived risk of HIV, PrEP eligibility, and PrEP use among young men who have sex with men in Washington, DC

Background In 2014, the CDC issued guidelines recommending pre-exposure prophylaxis (PrEP) for people at high risk of HIV infection. Recent studies indicate that low HIV risk perception may be a barrier to PrEP use among high-risk men who have sex with men (MSM). With efforts to increase awareness and uptake of PrEP, this analysis aimed to examine relationships between HIV risk perception, PrEP eligibility, and PrEP use specifically among young MSM, who accounted for an estimated 22% of new HIV diagnoses in 2015. Methods We analyzed cross-sectional survey data collected from MSM ages 16-25 in the Washington, DC metro area. The Perceived Risk of HIV Scale, a validated eight-item Likert scale, was adapted to measure risk perception (low or moderate/high). PrEP eligibility was determined using the MSM Risk Index, a six-item sexual risk behavior tool included in the 2014 CDC Clinical Providers’ Supplement. Participants reported their willingness to use PrEP and whether they currently used PrEP. Chi-square and Fisher's exact tests were used to assess differences in PrEP eligibility by risk perception categories. Adjusted odds ratios (aOR) were calculated using multivariable logistic regression to evaluate the associations between risk perception and PrEP willingness and use among PrEP-eligible participants. Results Of 188 participants with self-reported HIV-negative or HIV-unknown status, 149 (79.3%) had moderate/high perceived risk and 115 (61.2%) met index criteria for PrEP eligibility. A higher proportion of PrEP-eligible participants had moderate/high risk perception compared to those not considered eligible (86.1% vs. 68.5%, p=0.004). Among participants who were PrEP-eligible, 75.7% reported that they were willing to use PrEP. PrEP-eligible participants with moderate/high perceived risk had greater odds of willingness to take PrEP compared to those with low perceived risk (aOR 4.3, 95% CI: 1.4-13.8). Current PrEP use was reported by only 9.6% of PrEP-eligible participants and was not significantly associated with risk perception (aOR 1.7, 95% CI: 0.2-14.1). Conclusion HIV risk perception and willingness to use PrEP were both high among young MSM who met criteria for PrEP eligibility, yet few of these participants reported currently taking PrEP. Those who perceived their risk of HIV infection to be moderate or high were significantly more likely to be willing to take PrEP. These findings suggest the importance of risk perception as a correlate of PrEP acceptance and indicate that public health interventions to increase PrEP uptake may benefit from the inclusion of risk-related messaging tailored specifically to the young MSM population.