Social determinants of health and HIV Pre-Exposure Prophylaxis (PrEP) interest and use among young Black and Latinx sexual minority men.

Abstract

Young Black and Latinx sexual minority men (YBLSMM) have low use of HIV pre-exposure prophylaxis (PrEP), despite high rates of new HIV diagnosis. While unmet social determinants of health (SDOH) have been associated with low uptake of preventive health services, this association is unknown for PrEP. To understand the relationship between SDOH and PrEP adoption in this population, we analyzed data from an online survey of HIV-negative YBLSMM aged 18–29 in New York City (n = 143). Participants completed a 17-item SDOH needs scale measuring basic, health/social-services, and economic needs. We used regression models to examine associations of unmet SDOH with outcomes of intention to use PrEP and current PrEP use. Of those not on PrEP (n = 114), 69 (61%) intended to use PrEP. More unmet SDOH needs overall were associated with intention to use PrEP (OR 1.4; 95% CI 1.1, 2.0), as were more unmet basic needs (OR 1.7; 95% CI 1.1, 2.5) and more unmet economic needs (OR 1.3; 95% CI 1.0, 1.7). Unmet SDOH needs were not associated with current PrEP use. Findings suggest that intention to use PrEP among YBLSMM is a likely marker of unmet SDOH needs, as YBLSMM with unmet needs may have limited resources to support moving from intention to actual use. Future research should evaluate programs engaging YBLSMM intending to use PrEP with interventions to screen for and address SDOH.