Article Data

  • Views 3026
  • Dowloads 158

Original Research

Open Access

RECOMMENDATIONS FOR INTERVENTION CONTENT TO ENHANCE HIV  PRE-EXPOSURE PROPHYLAXIS UPTAKE AMONG MEN WHO HAVE SEX  WITH MEN RECEIVING CARE AT SEXUALLY TRANSMITTED DISEASE CLINICS

  • Amy S. Nunn1
  • Genoviva Sowemimo-Coker2
  • Jacob J. van den Berg1,2
  • Cassandra Sutten Coats1
  • Collette Sosnowy2
  • Siena Napoleon2
  • Kevin Cormier2
  • Philip A. Chan1,2
  • Ethan Moitra3

1Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA

2Department of Medicine, Brown University, Providence, RI, USA

3Department of Psychiatry & Human Behavior, Brown University, Providence, RI, USA

DOI: 10.15586/jomh.v16i3.198 Vol.16,Issue 3,July 2020 pp.47-59

Published: 16 July 2020

*Corresponding Author(s): Amy S. Nunn E-mail: amy_nunn@brown.edu

Abstract

Background and objective

Pre-exposure prophylaxis (PrEP) uptake has been suboptimal. Sexually transmitted disease (STD) clinics provide important opportunities to scale PrEP uptake.

Material and methods 

To inform the development of a brief intervention to enhance PrEP uptake in STD clinics, we conducted 32 qualitative interviews to explore barriers and facilitators of PrEP uptake among PrEP eligible, PrEP naïve, and men who have sex with men (MSM) presenting for STD screening services. We also solicited input for intervention components to enhance PrEP uptake at STD clinics.

Results

Most participants’ self-perceived HIV risks were low despite reporting unprotected anal intercourse. Many were reluctant to take any medications, expressed apprehension about perceived side effects of PrEP, and were unaware of how to obtain PrEP. Participants recommended that interventions focusing on enhancing PrEP uptake in STD clinics should include: culturally tailored educational materials about PrEP, informational graphics indicating PrEP’s relative efficacy in reducing HIV transmission risks, and comprehensive PrEP nav-igation. Most participants did not feel strongly about gender, race or ethnicity of providers; however, nearly all preferred gay-affirming providers. Brief interventions to enhance PrEP uptake among MSM in STD clinics should include efforts to raise self-awareness of HIV risk, provide information about PrEP’s efficacy relative to other interventions, underscore PrEP’s relatively few side effects, and provide culturally tailored messaging.

Keywords

intervention; men who have sex with men (MSM); pre-exposure prophylaxis (PrEP); uptake

Cite and Share

Amy S. Nunn,Genoviva Sowemimo-Coker,Jacob J. van den Berg,Cassandra Sutten Coats,Collette Sosnowy,Siena Napoleon,Kevin Cormier,Philip A. Chan,Ethan Moitra. RECOMMENDATIONS FOR INTERVENTION CONTENT TO ENHANCE HIV PRE-EXPOSURE PROPHYLAXIS UPTAKE AMONG MEN WHO HAVE SEX WITH MEN RECEIVING CARE AT SEXUALLY TRANSMITTED DISEASE CLINICS. Journal of Men's Health. 2020. 16(3);47-59.

References

1. cdc-hiv-surveillance-report-2017-vol-29.pdf [Internet]. [cited 2018 Apr 19]. Available from: https://www.cdc.gov/hiv/pdf/library/reports/surveillance/

cdc- hiv-surveillance-report-2017-vol-29.pdf

2. cdc-hiv-prep-guidelines-2017.pdf [Internet]. [cited 2019 Oct 10]. Available from: https://www.cdc.gov/hiv/pdf/risk/prep/cdc-hiv-prep-guidelines-2017.pdf

3. Shrestha RK, Sansom SL, Purcell DW. Assessing HIV acquisition risks among men who have sex with men in the United States of America. Rev Panam Salud Publica Pan Am J Public Health. 2016 Dec;40(6):474–8. PMID: 28718498.

4. Hojilla JC, Vlahov D, Crouch P-C, et al. HIV pre-exposure prophylaxis (PrEP) uptake and retention among men who have sex with men in a community- based sexual health clinic. AIDS Behav. 2018 Apr 1;22(4):1096–9. http://dx.doi.org/10.1007/s10461-017-2009-x

5. Volk JE, Marcus JL, Phengrasamy T, et al. No new HIV infections with increasing use of HIV preex-posure prophylaxis in a clinical practice setting. Clin Infect Dis. 2015 Nov 15;61(10):1601–3. http://

dx. doi.org/10.1093/cid/civ778

6. Liu AY, Cohen SE, Vittinghoff E, et al. Pre-exposure prophylaxis for HIV infection integrated with municipal- and community-based sexual health services. JAMA Intern Med. 2016 Jan;176(1):75–84. http://dx.doi.org/10.1001/jamainternmed.2015.4683

7. Siegler AJ, Mouhanna F, Giler RM, et al. The prevalence of pre-exposure prophylaxis use and the pre- exposure prophylaxis–to-need ratio in the fourth quarter of 2017, United States. Ann Epidemiol [Internet]. 2018 Jun 15. Available from: http://www.sciencedirect.com/science/article/pii/S1047279718301078

8. Vital signs: HIV diagnosis, care, and treatment among persons living with HIV – United States, 2011 [Internet]. [cited 2018 Nov 29]. Available from: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6347a5.htm

9. Changes in Truvada® for HIV pre-exposure pro-phylaxis utilization in the USA: 2012–2016 –Disparities [Internet]. [cited 2019 Apr 30]. Available from: http://www.natap.org/2017/IAS/IAS_72.htm

10. HIVSTD.pdf [Internet]. [cited 2018 Jun 18]. Available from: http://www.health.ri.gov/publications/surveillance/2016/HIVSTD.pdf

11. Chan PA, Glynn TR, Oldenburg CE, et al. Implementation of pre-exposure prophylaxis for HIV prevention among men who have sex with men at a New England sexually transmitted diseases clinic. Sex Transm Dis. 2016 Nov;43(11):717–23. http://dx.doi.org/10.1097/OLQ.0000000000000514

12. Corneli AL, Deese J, Wang M, et al. FEM-PrEP: Adherence patterns and factors associated with adherence to a daily oral study product for pre- exposure prophylaxis. J Acquir Immune Defic Syndr. 2014 Jul;66(3):324–31. http://dx.doi. org/10.1097/QAI.0000000000000158

13. Goedel WC, Mayer KH, Mimiaga MJ, Duncan DT. Considerable interest in pre-exposure prophylaxis uptake among men who have sex with men recruited from a popular geosocial-networking smartphone application in London. Glob Public Health. 2019 Jan 2;14(1):112–21. http://dx.doi.org/10.1080/17441692.2 017.1391859

14. Arnold T, Brinkley-Rubinstein L, Chan PA, et al. Social, structural, behavioral and clinical factors influ-encing retention in pre-exposure prophylaxis (PrEP) care in Mississippi. PLoS One. 2017;12(2):e0172354. http://dx.doi.org/10.1371/journal.pone.0172354

15. Franks J, Hirsch-Moverman Y, Loquere AS, et al. Sex, PrEP, and stigma: Experiences with HIV pre-exposure prophylaxis among New York City MSM participating in the HPTN 067/ADAPT study. AIDS Behav. 2018 Apr 1;22(4):1139–49. http://dx. doi.org/10.1007/s10461-017-1964-6

16. Pérez-Figueroa RE, Kapadia F, Barton SC, et al. Acceptability of PrEP uptake among racially/ethnically diverse young men who have sex with men: The P18 study. AIDS Educ Prev Off Publ Int Soc AIDS Educ. 2015 Apr;27(2):112–25. http://dx. doi.org/10.1521/aeap.2015.27.2.112

17. Golub SA, Gamarel KE, Rendina HJ, et al. From efficacy to effectiveness: Facilitators and barriers to PrEP acceptability and motivations for adherence among MSM and transgender women in New York City. AIDS Patient Care STDs. 2013 Apr;27(4):248–

54. http://dx.doi.org/10.1089/apc.2012.0419

18. Disparities in PrEP uptake among primary care patients screened for HIV/STIS in SF | CROI Conference [Internet]. 2018 [cited 2018 Aug 1]. Available from: http://www.croiconference.org/sessions/disparities-prep-uptake-among-primary- care-patients-screened-hivstis-sf

19. cdc-hiv-prep-guidelines-2017.pdf [Internet]. [cited 2019 May 2]. Available from: https://www.cdc.gov/hiv/pdf/risk/prep/cdc-hiv-prep-guidelines-2017.pdf

20. Smith DK, Pan Y, Rose CE, et al. A brief screen-ing tool to assess the risk of contracting HIV infec-tion among active injection drug users. J Addict Med. 2015;9(3):226–32. http://dx.doi.org/10.1097/ADM.0000000000000123

21. “Unsatisfactory saturation”: A critical exploration of the notion of saturated sample sizes in qualitative research – Michelle O’Reilly, Nicola Parker, 2013 [Internet]. [cited 2019 Apr 30]. Available from: https://journals.sagepub. com/doi/abs/10.1177/146879411244610622. Wang Z, Lau JTF, Fang Y, et al. Prevalence of actual uptake and willingness to use pre-exposure prophy-laxis to prevent HIV acquisition among men who have sex with men in Hong Kong, China. PLoS One [Internet]. 2018 Feb 12 [cited 2018 Nov 26];13(2). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5809018/

23. Bauermeister JA, Meanley S, Pingel E, et al. PrEP awareness and perceived barriers among single young men who have sex with men in the United States. Curr HIV Res. 2013 Oct;11(7):520–7. http://

dx. doi.org/10.2174/1570162X12666140129100411

24. Blumenthal J, Jain S, Mulvihill E, et al. Perceived versus calculated HIV risk: Implications for pre-exposure prophylaxis uptake in a random-ized trial of men who have sex with men. J Acquir Immune Defic Syndr [Internet]. 2018 Oct 29 [cited 2018 Nov 26]; Publish ahead of print. Available from: https://insights.ovid.com/crossref?an=00126334-900000000-96526

25. Yombi JC, Mertes H. Treatment as prevention for HIV infection: Current data, challenges, and global perspectives. AIDS Rev. 2019 Jan 30;20(3):1199. http://dx.doi.org/10.24875/AIDSRev.M18000024

26. Evolving models and ongoing challenges for HIV pre-exposure prophylaxis implementation in the … – Europe PMC Article – Europe PMC [Internet]. [cited 2019 Apr 30]. Available from: https://europepmc.org/articles/pmc5762416

27. Service delivery and patient outcomes in Ryan White HIV/AIDS program–funded and – nonfunded health care facilities in the United States. |Health disparities | JAMA Internal Medicine |JAMA Network [Internet]. [cited 2019 Apr 30]. Available from: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2430794

28. Bradley H, Viall AH, Wortley PM, et al. Ryan White HIV/AIDS program assistance and HIV treatment outcomes. Clin Infect Dis. 2016 Jan 1;62(1):90–8. http://dx.doi.org/10.1093/cid/civ708

29. Cohen et al., Antiretroviral Therapy for the Prevention of HIV-1 Transmission. N Engl J Med. 2016.

30. Grant et al. Preexposure Chemoprophylaxis for HIV Prevention in Men Who Have Sex with Men. N Engl J Med. 2010.

31. Rodger et al. Sexual Activity Without Condoms and Risk of HIV Transmission in Serodifferent Couples When the HIV-Positive Partner Is Using Suppressive Antiretroviral Therapy. JAMA. 2016.

32. Smith et al. Condom effectiveness for HIV preven-tion by consistency of use among men who have sex with men in the United States. J Acquir Immune Defic Syndr. 1999.

33. Vallabhaneni et al. Seroadaptive practices: associa-tion with HIV acquisition among HIV-negative men who have sex with men. PLoS One. 2012.

34. WHO I Condoms for HIV prevention [Internet]. WHO. [cited 2017 Dec 6]. Available from http://www.who.int/hiv/topics/condoms/en

35. Diepstra KL, Rhodes AG, Bono RS, et al. Comprehensive Ryan White assistance and human immunodeficiency virus clinical outcomes: Retention in care and viral suppression in a Medicaid nonexpansion state. Clin Infect Dis. 2017 Aug 15;65(4):619–25. http://dx.doi.org/10.1093/cid/cix380

36. Jones EA, Linas BP, Truong V, et al. Budgetary impact analysis of a primary care-based hepatitis C treatment program: Effects of 340B Drug Pricing Program. Smith DK, editor. PLoS One. 2019 Mar 14;14(3):e0213745. http://dx.doi.org/10.1371/journal. pone.0213745

37. Cahill S, Taylor SW, Elsesser SA, et al. Stigma, med-ical mistrust, and perceived racism may affect PrEP awareness and uptake in black compared to white gay and bisexual men in Jackson, Mississippi and Boston, Massachusetts. AIDS Care. 2017 Nov 2;29(11):1351–

8. http://dx.doi.org/10.1080/09540121.2017.1300633

38. Holloway I, Dougherty R, Gildner J, et al. PrEP uptake, adherence, and discontinuation among California YMSM using geosocial network-ing applications. J Acquir Immune Defic Syndr. 2017 Jan 1;74(1):15–20. http://dx.doi.org/10.1097/QAI.0000000000001164

39. Nunn AS, Brinkley-Rubinstein L, Oldenburg CE, et al. Defining the HIV pre-exposure pro-phylaxis care continuum. AIDS Lond Engl. 2017 Mar 13;31(5):731–4. http://dx.doi.org/10.1097/QAD.0000000000001385

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Directory of Open Access Journals (DOAJ) DOAJ is a unique and extensive index of diverse open access journals from around the world, driven by a growing community, committed to ensuring quality content is freely available online for everyone.

SCImago The SCImago Journal & Country Rank is a publicly available portal that includes the journals and country scientific indicators developed from the information contained in the Scopus® database (Elsevier B.V.)

Publication Forum - JUFO (Federation of Finnish Learned Societies) Publication Forum is a classification of publication channels created by the Finnish scientific community to support the quality assessment of academic research.

Scopus: CiteScore 0.7 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Norwegian Register for Scientific Journals, Series and Publishers Search for publication channels (journals, series and publishers) in the Norwegian Register for Scientific Journals, Series and Publishers to see if they are considered as scientific. (https://kanalregister.hkdir.no/publiseringskanaler/Forside).

Submission Turnaround Time

Conferences

Top