BACKGROUND: Though HIV incidence in the United States has remained stable at about 50,000 annual estimated new infections, men who have sex with men (MSM) account for nearly two-thirds of new infections, with African Americans and Hispanics/Latinos disproportionately affected. With the availability of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), persons at risk of infection can reduce their risk by taking a daily dose of antiretroviral therapy (ART). PrEP is a key pillar of the NYS Ending the Epidemic initiative (ETE) and the National HIV/AIDS Strategy (NHAS) and as such this biomedical intervention is a powerful tool to prevent HIV; however, little is known about knowledge of PrEP among MSM over time.
METHODS: Data was obtained from the 2011 (n=302), and 2014 (n=304) MSM cycles of the National HIV Behavioral Surveillance System (NHBS) conducted in Nassau and Suffolk Counties (Long Island), NY. Men were recruited using venue-based sampling at locations of social congregation (i.e., bars, gay pride events, social clubs, etc.). Eligible participants were 18 years or older, born male/self-identified as male, reported oral/anal sex with a man, resident of Long Island, and able to complete the survey in English or Spanish. Incentivized, anonymous face-to-face standardized interviews and voluntary HIV and HCV testing were conducted. The key variable is knowledge of PrEP/PEP. Binary logistic regression is used to compare knowledge of PrEP/PEP over time.
RESULTS: Knowledge of PrEP/PEP is low overall, but increased over time. In the 2011, 16% of participants had heard of PrEP/PEP. By 2014 nearly half (45%) of participants had heard of PrEP/PEP – a statistically significant increase controlling for education, race, HIV test result, and self-reported unprotected sex. Significant factors associated with increased knowledge of PrEP/PEP include higher education, younger age, and positive HIV test result. Self-reported Hispanic/Latino status and reporting having engaged in unprotected vaginal sex within the last year were associated with less knowledge.
CONCLUSIONS: Knowledge of PrEP/PEP in MSM increased over time, though clear differences in PrEP/PEP knowledge by race and education were documented. These findings point to success in disseminating information about PrEP/PEP to non-Hispanic black and non-Hispanic white MSM with higher education levels, while highlighting the need for more specific educational efforts regarding this highly effective intervention for Hispanic/Latino MSM, specifically MSM with lower educational levels. Increasing knowledge and uptake of PrEP/PEP among all MSM at risk is pivotal in reaching the goals of the NYS ETE initiative and the NHAS.