HIV testing and pre-exposure prophylaxis (PrEP) use, familiarity, and attitudes among gay and bisexual men in the United States: A national probability sample of three birth cohorts.

Phillip L Hammack,Ilan H Meyer,Evan A Krueger,David M Frost,Marguerita Lightfoot

doi:10.1371/journal.pone.0202806

Abstract

This study examined HIV testing and use, familiarity, and attitudes toward pre-exposure prophylaxis (PrEP) among HIV-negative gay and bisexual men in the United States. A national probability sample (N = 470) of three age cohorts (18–25, 34–41, and 52–59 years) completed a survey between March, 2016 and March, 2017. Most men did not meet CDC recommendations for HIV testing, and 25.2% of men in the younger cohort had never tested. Only 4.1% used PrEP across cohorts. Visiting an LGBT clinic and searching for LGBT resources online were associated with PrEP use. Men in the middle cohort were more familiar with PrEP (79%) than men in the younger (52%) and older (57%) cohorts. Bisexual and non-urban men were less familiar with PrEP. Attitudes were positive among most men (68.4%) familiar with PrEP. Findings suggest that most men potentially at risk for HIV do not meet CDC guidelines for testing, and PrEP use continues to be minimal. 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.

Highlights

HIV continues to be a major public health concern, in particular for gay, bisexual, and other men who have sex with men in the United States, who account for 70% of new HIV infections annually[1]
Despite recent public health efforts focused on educating gay, bisexual, and other men who have sex with men about HIV testing and promoting the availability of pre-exposure prophylaxis (PrEP), our findings suggest that health educational efforts are not adequately reaching sizable and distinct groups of men at risk for HIV infection
Our finding that 25% of young gay/bisexual men who are sexually active with a same-sex partner have never been tested for HIV is striking

Summary

Introduction

HIV continues to be a major public health concern, in particular for gay, bisexual, and other men who have sex with men in the United States, who account for 70% of new HIV infections annually[1]. Of these new infections, African American men account for the highest number (38%), followed by Latino (28%) and White (28%) men[2]. Over 60% of those who are undiagnosed are gay, bisexual, and other men who have sex with men[3], which is why the Centers for Disease Control and Prevention (CDC) recommends annual screening for this population.

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Conclusion