September 19, 2019
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Black, Hispanic MSM less likely to have discussed PrEP with a doctor

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Preliminary data published in MMWR showed that most men who have sex with men, or MSM, are aware of pre-exposure prophylaxis, or PrEP, for HIV prevention, but that black and Hispanic MSM were much less likely than white MSM to have ever discussed it with a health care provider.

The report was published ahead of National Gay Men’s HIV/AIDS Awareness Day, which is Sept. 27.

According to the report, MSM accounted for 67% of new HIV infection diagnoses in 2017. Under an initiative announced during this year’s State of the Union, officials hope to reduce new HIV infections in the U.S. by 90% by 2030. Increasing PrEP use in MSM is an integral part of the plan.

“Black and Hispanic MSM currently experience substantially higher HIV incidence than do white MSM,” Dafna Kanny, PhD, and colleagues from the CDC’s Division of HIV/AIDS Prevention, wrote in MMWR. “Because PrEP effectively prevents sexual HIV transmission, racial/ethnic disparities in PrEP use might further increase disparities in HIV incidence.”

They noted that social, structural and epidemiologic factors determine these disparities, and that prevention efforts that address these determinants “have the potential to decrease disparities along the HIV PrEP continuum of care.”

In 2017, the researchers interviewed 10,104 sexually active MSM in 23 U.S. urban areas. In their analysis, they included 4,056 (40%) MSM who tested negative for HIV and likely met the clinical indications for PrEP. Of these, 1,843 were white, 1,251 were Hispanic and 962 were black, according to the report.

Among them, 95% of white, 87% of Hispanic and 86% of black MSM were aware of PrEP (white vs. Hispanic adjusted prevalence ratio [PR] = 1.1; 95% CI, 1.0-1.1; white vs. black aPR = 1.1; 95% CI, 1.0-1.1). Although most participants knew about PrEP, only 58% of white, 44% of Hispanic and 43% of black MSM reported discussing it with a health care provider within the past year (white vs. Hispanic aPR = 1.2; 95% CI, 1.1-1.3; white vs. black aPR = 1.2; 95% CI, 1.1-1.3). And just 42% of white, 30% of Hispanic and 26% of black MSM reported taking PrEP within the past year (white vs. Hispanic aPR = 1.2; 95% CI = 1.1-1.3; white vs. black adjusted PR = 1.4; 95% CI, 1.2-1.6).

“Further efforts to improve outcomes along the HIV PrEP continuum of care for all MSM and to address racial/ethnic disparities, particularly in discussion with a health care provider and use, will be critical to reducing persistent racial/ethnic disparities in HIV incidence,” the researchers wrote. “These actions would help achieve the nation’s goal of preventing new HIV infections.” – by Joe Gramigna

Disclosures: The authors report no relevant financial disclosures.