Barriers to preexposure prophylaxis use among individuals with recently acquired HIV infection in Northern California
- 10 October 2018
- journal article
- research article
- Published by Taylor & Francis Ltd in AIDS Care
- Vol. 31 (5), 536-544
- https://doi.org/10.1080/09540121.2018.1533238
Abstract
Barriers to HIV preexposure prophylaxis (PrEP) use have not been well-characterized in people who became HIV-infected, all of whom could have benefited from PrEP. We invited Kaiser Permanente Northern California members diagnosed with HIV during 2014–2016, following a negative HIV test in the prior year, to complete a survey assessing barriers to PrEP use before HIV diagnosis. Of 268 patients surveyed, 122 (46%) responded. Median age was 36, most (84%) were men who have sex with men, and 64% were of minority racial/ethnic background. Thirty-six (30%) had discussed PrEP with a provider, of whom 10 were diagnosed with HIV at PrEP intake. Overall, only 5 (4.1%) had used PrEP, and all 5 discontinued before diagnosis. Among all respondents, the most common barrier to PrEP use was lack of PrEP awareness (51%). Among those aware of PrEP, the most common barriers were cost/insurance concerns (36%) and perceived low risk for HIV (24%). Lack of PrEP awareness ranged from 39% among those aged 25–34 to 88% among those aged P = 0.011), and from 33% among Hispanics to 69% among Blacks (P = 0.055). Increasing awareness and affordability of PrEP, and facilitating accurate assessment of HIV risk, are critical to reducing missed opportunities for PrEP.Keywords
Funding Information
- Kaiser Permanente (CN-16-2723)
- National Institute of Allergy and Infectious Diseases (K01 AI122853)
This publication has 31 references indexed in Scilit:
- Barriers and Facilitators to Oral PrEP Use Among Transgender Women in New York CityAIDS and Behavior, 2018
- Facilitators and Barriers to Pre-Exposure Prophylaxis (PrEP) Use Among Black Individuals in the United States: Results from the National Survey on HIV in the Black Community (NSHBC)AIDS and Behavior, 2018
- Trends in Awareness and Use of HIV PrEP Among Gay, Bisexual, and Other Men who have Sex with Men in Vancouver, Canada 2012–2016AIDS and Behavior, 2018
- Facilitators and Barriers to Pre-Exposure Prophylaxis Willingness Among Young Men Who Have Sex with Men Who Use Geosocial Networking Applications in CaliforniaAIDS Patient Care and STDs, 2017
- Machine Learning for Healthcare: On the Verge of a Major Shift in Healthcare EpidemiologyClinical Infectious Diseases, 2017
- Limited awareness of pre-exposure prophylaxis among black men who have sex with men and transgender women in New York cityAIDS Care, 2017
- Social, structural, behavioral and clinical factors influencing retention in Pre-Exposure Prophylaxis (PrEP) care in MississippiPLOS ONE, 2017
- PrEP Awareness, Familiarity, Comfort, and Prescribing Experience among US Primary Care Providers and HIV SpecialistsAIDS and Behavior, 2016
- Implementation of Preexposure Prophylaxis for Human Immunodeficiency Virus Prevention Among Men Who Have Sex With Men at a New England Sexually Transmitted Diseases ClinicSexually Transmitted Diseases, 2016
- Uptake of HIV Preexposure Prophylaxis Among Commercially Insured Persons—United States, 2010–2014Clinical Infectious Diseases, 2016