20th International AIDS Conference - Melbourne, Australia


THPE187 - Poster Exhibition

High levels of interest in PrEP and baseline risk behaviors among MSM enrolled in the US PrEP Demonstration (Demo) project

R. Elion1, S. Doblecki-Lewis2, S. Cohen3, J. Castro2, S. Buchbinder4, Y. Estrada5, O. Bacon6, M. Kolber5, T. Matheson7, M. Coleman1, J. Schmandt1, A. Liu8

1Whitman-Walker Health, Washington, United States, 2University of Miami, Infectious Disease, Miami, United States, 3San Francisco Department of Public Health, Population Health Division, San Francisco, United States, 4San Francisco Department of Public Health, Bridge HIV, San Francisco, United States, 5University of Miami, Medicine, Miami, United States, 6University of California San Francisco, HIV Division, San Francisco, United States, 7San Francisco Department of Public Health, Counseling, San Francisco, United States, 8San Francisco Department of Health, HIV Prevention Intervention Studies, San Francisco, United States

Background: Men who have sex with men (MSM) and transgender women (TGW) are prioritized populations for pre-exposure prophylaxis (PrEP). However, level of interest and characteristics of individuals electing to take PrEP in real-world settings are unknown.
Methods: The Demo Project is an open-label PrEP demonstration project that has enrolled at-risk MSM/TGW through 2 STD clinics (San Francisco and Miami) and a community health center (Washington, DC). Participants receive quarterly HIV/STD testing, risk-reduction counseling, and daily oral emtrictabine/tenofovir for 48 weeks. We describe baseline demographics, risk behaviors, HIV-risk perception, and STD prevalence (gonorrhea, chlamydia, syphilis) at screening for the enrolled cohort.
Results: From September 2012 to January 2014, 1108 clients were approached for study participation, 959were potentially eligible, and 557 enrolled (uptake 58.1%) .. Mean age was 35. The majority (68%) were White, 10% Black, 17% “Other” and 5% Asian; 35% reported Latino ethnicity, including 74% in Miami. Almost all (98%) were MSM; 7 (1.3%) identified as TGW. Participants in Miami were younger, had lower education, and were less likely to have a primary-care provider or health insurance (all p< 0.05). The most common reasons for enrollment were to protect oneself against HIV (65%), help fight HIV (15%) and having an HIV-infected partner (11%); most (70%) were somewhat to extremely worried about getting HIV. Overall, 37% reported recent use of cocaine, crack, methamphetamine, or club drugs, and 12% binge drinking. Approximately one-quarter had an HIV-infected primary partner. The majority reported condomless anal sex, including a significant proportion with HIV-positive partners (table); 45% reported ≥10 episodes of condomless anal sex in the past 3 months. At baseline, 16% tested positive for gonorrhea, 14% for chlamydia, and 4.3% had early syphilis.
Conclusions: Participation in PrEP is high among a diverse population of MSM when offered as part of a comprehensive prevention program in STD and community health clinics. Enrolled participants demonstrated multiple indices of HIV-risk. Additional strategies are needed to engage transgender populations in PrEP programs.

Condomless anal sex past 3 monthsOverallWith HIV-negative PartnerWith Unkown HIV - serostatus partnerWith HIV + positive Partner
Condomless anal sex (insertive or receptive)481 (86%)335 (60%)197 (35%)226 (41%)
Condomless receptive anal sex353 (63%(248 (45%)114 (21%)132 (24%)
[Serostatus and unprotected sex %]

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