Only 4 percent of gay and bisexual men in the United States reported using pre-exposure prophylaxis, or PrEP; this according to a new study recently published in PLOS ONE. The study also revealed that bisexual and non-urban men were less likely than gay men to use PrEP; while visiting an LGBT clinic and searching for information online on LGBT sources were associated with PrEP use.
PrEP is a pill taken daily that reduces the likelihood of being infected with HIV by over 99 percent and is recommended by the Centers for Disease Control and Prevention (CDC) for those at high risk of HIV/AIDS. Currently, Truvada, manufactured by Gilead, is the only form of PrEP approved by the Food & Drug Administration.
The study used data from the Generations Study using a national probability sample of 470 male participants from three age cohorts: 18-25, 34-41, and 52-59. Researchers examined HIV testing and use, familiarity, and attitudes toward PrEP among HIV-negative gay and bisexual men in the U.S. Participants completed the survey between March, 2016 and March, 2017.
ACCESS, FAMILIARITY & ATTITUDES
“The extremely low rate of PrEP use, while not surprising given barriers to access in various parts of the country, is disappointing,” said Professor Phillip Hammack of the University of California Santa Cruz’s Department of Psychology. Since it was approved for PrEP six years ago, the wholesale price for Truvada in the U.S. has risen 45 percent, with the list price for a 30-day supply close to $2,000.
Despite low usage, a majority of particpants — 60 percent — reported that they were familiar with PrEP, with the middle cohort, ages 34-41, reporting the highest familiarity at 79 percent. Attitudes toward PrEP were also positive among most men — 68 percent of all participants, with the younger cohort, ages 18-25, at 76 percent.
The study also showed that most men did not meet the CDC recommndations for annual HIV testing with more than 25 percent of men in the younger cohort, ages 18-25, and 8 percent of men over 25 never having been tested for HIV.
“I worry especially about younger men who didn’t grow up with the concerns of HIV that men of older generations did,” said Hammack. “The low rate of HIV testing probably reflects a degree of complacency and cultural amnesia about AIDS.”
“Our findings suggest that health education efforts are not adequately reaching sizable groups of men at risk for HIV infection,” says principal investigator Ilan H. Meyer of the Williams Institute at the UCLA School of Law. “It is alarming that high-risk populations of men who are sexually active with same-sex partners are not being tested or taking advantage of treatment advances to prevent the spread of HIV.”
The study suggests that “efforts to educate gay and bisexual men about HIV risk and prevention need to be reinvigorated and expanded to include non-gay-identified and non-urban men”.
The study was supported by the National Institute of Child Health and Human Development (NICHD) of the National Institutes of Health.