Survey reveals ‘missed opportunities’ for discussions about PrEP between MSM, providers
Although a high percentage of pre-exposure prophylaxis-naive and HIV-negative men who have sex with men reported at least one encounter with a health care provider in the previous year, only 31% remembered a provider talking about PrEP, according to findings published in Open Forum Infectious Diseases.
“In 2017, Fulton County had the highest rate of HIV diagnoses in Georgia. Over 93% of the new HIV diagnoses among men in the county are among men who have sex with men, or MSM,” Susanna L. Trost, MPH, of the department of epidemiology at Rollins School of Public Health, Emory University, told Healio. “National surveillance reports had shown that the uptake of HIV PrEP in the U.S. South was low compared with the HIV burden in the region and the local health department had initiated a campaign STOPHIVATL which had, as one of its goals, a plan to increase awareness and uptake of effective HIV preventive measures like PrEP within the Atlanta community.”
According to Trost, this survey was designed to obtain estimates of HIV risk behaviors, PrEP use and barriers to PrEP uptake among high-risk individuals.
“Understanding access to and utilization of PrEP services, as well as attitudes about and barriers to PrEP, can guide HIV prevention programs in Fulton County,” she said.
Trost and colleagues used data that was obtained in a 2018 venue-based, cross-sectional survey and assessed the factors associated with health care-seeking behaviors, talking about PrEP with a provider and barriers to PrEP uptake among MSM. They also evaluated associations between outcomes and respondents’ sociodemographic characteristics and sexual behaviors.
The median age of respondents was 28 years (range, 18-70 years). More than half identified as black/African American (56%). A minority (9%) reported drug use — injection or non-injection — or being diagnosed with a bacterial STI (3%) in the previous 6 months. Slightly more than half (57%) noted inconsistent condom use.
The survey demonstrated that 51% of the 478 MSM surveyed (n = 247) were PrEP naive and HIV negative. Additionally, although 85% of PrEP-naive MSM reported seeing a health care provider in the past year, only 31% remembered any provider talking about PrEP. According to the study, the reasons given most often for not taking PrEP included low perception of personal risk for HIV acquisition (37%) and not knowing enough about PrEP (35%). Individuals who interacted a provider in the last year were less likely to name lack of knowledge as a barrier to use PrEP than those who did not.
“Despite most MSM visiting a health care provider in the last year, there were missed opportunities for PrEP discussion and initiation during those clinical encounters,” Trost said. “Equipping providers with the resources and information needed to discuss PrEP with high-risk patients is important for increasing PrEP uptake and decreasing HIV incidence.”