20th International AIDS Conference - Melbourne, Australia


THPE191 - Poster Exhibition

PrEP awareness in men who have sex with men (MSM) and transgender women (TGW) assessed for participation in the US PrEP demonstration project

O. Bacon1,2, E. Vittinghoff3, S. Cohen1, S. Doblecki-Lewis4, T. Matheson5, M. Kolber4, W. Chege6, R. Elion7, R.W. Blue1, Y. Estrada4, N. Trainor1, S. Buchbinder5, A. Liu5

1San Francisco Department of Public Health, San Francisco City Clinic, San Francisco, United States, 2University of California San Francisco, HIV Division, San Francisco, United States, 3University of California, San Francisco, Department of Epidemiology & Biostatistics, San Francisco, United States, 4University of Miami-Miller School of Medicine, Miami, United States, 5San Francisco Department of Public Health, Bridge HIV, San Francisco, United States, 6National Institutes of Health, NIAID, Division of AIDS, Bethesda, United States, 7Whitman-Walker Health, Washington, United States

Background: Since FDA approval in July 2012, uptake of PrEP in the US has been limited. Identifying correlates of PrEP knowledge may help identify groups that need additional outreach. We evaluated PrEP awareness among MSM and TGW who were assessed for participation in the US PrEP Demonstration (Demo) project.
Methods: The Demo Project is a 48-week, open-label study of daily emtricitabine/tenofovir for HIV prevention at STD clinics in San Francisco (SF) and Miami, and a community health center in Washington, DC (DC). During screening, data on PrEP awareness, risk behaviors, HIV risk perception, and demographics were collected from HIV-uninfected MSM and TGW who requested PrEP (self-referrals) or were referred to the study by clinic staff while receiving services (clinic referrals). Predictors of PrEP awareness were assessed using multivariate logistic regression.
Results: Between 9/2012 and 1/2014, 1108 clients were assessed for participation in The Demo Project, 988 of whom were asked about PrEP awareness. Most (59%) were aware of PrEP (i.e., had heard of PrEP from someone other than clinic personnel), although this varied by site (70% SF, 34% Miami, 60% DC, p< 0.001). PrEP awareness was lower among clinic referrals (40%). In adjusted analyses, PrEP awareness was associated with being from the SF site, white race (in SF only), higher levels of education, increased perception of HIV risk, and frequency of anal sex with HIV+ partners (all p< 0.05). 39% had heard about PrEP from a friend/sex partner, 31% in the media, 18% from a medical provider/clinic, and 12% at a community organization. Hearing about PrEP through one''s social/sexual network was highly associated with self-referral for PrEP (OR 3.16, 95%CI 2.20-4.54, p< 0.001) and increased over the study interval (p=0.0017).
Conclusions: PrEP awareness among clients assessed for participation in The Demo Project varied by study site, race, education level, and risk perception. Efforts to tailor messaging to address disparities in prep awareness are needed. Sexual health clinics can play an important role in increasing PrEP awareness. Social and sexual networks may be important intervention targets to increase PrEP awareness and encourage individuals to seek out sources of PrEP in their communities.

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