Saturday, March 5, 2016

Knowledge, Attitudes, and Acceptability of Pre-Exposure Prophylaxis among Individuals Living with HIV in an Urban HIV Clinic

Introduction
Pre-exposure prophylaxis (PrEP) is an effective tool to reduce HIV transmission. The primary objective of this study was to assess awareness of PrEP by individuals living with HIV (HIV+) and acceptance of its use for their HIV negative (HIV-) partners.

Methods
A cross sectional survey was conducted among individuals living with HIV who received care at an urban HIV clinic between January 2013 and June 2013. The survey examined knowledge, attitudes, and acceptability of PrEP, and perception of transmission risk of HIV. Chi-Square test and Fisher's Exact test were used to compare proportions.

Results
Among 206 subjects living with HIV, 15.3% (32) had heard of PrEP. Men who have sex with men (MSM) were more likely to be aware of PrEP than all others (p = 0.003). Once educated about PrEP those who believed PrEP would reduce their partner’s risk for HIV were more likely to recommend PrEP to their partner (p<0.001). 92% of all respondents said they would be “extremely likely/likely” to discuss PrEP use with their provider. Of 159 subjects whose main partner was HIV-, MSM (p = 0.007), male participants (p = 0.044), and those who were consistently taking meds (p = 0.049) were more likely to be aware of PrEP. Those who perceived they were at risk of transmitting HIV (p<0.001) and those who were consistently taking meds (0.049) were more likely to agree that PrEP could reduce the risk of HIV to their partners.

Conclusion
This study illustrates a low awareness of PrEP but once educated the willingness of a cohort of individuals living with HIV to recommend PrEP to their partners. Our findings demonstrate the importance of providers informing their patients living with HIV about PrEP, as these persons are an underutilized link to support the uptake of PrEP by their HIV- partners.

Factors Associated with PrEP Awareness and Acceptance (206).
Awareness: Have you ever heard of pre-exposure prophylaxis (PrEP) before?
Yes N (%)No N (%)p-value
Sexual Orientation(Non MSM includes heterosexual, lesbian, and questioning/don’t’ know)Non- MSM (153)17(11.9)135 (89%)0.003
MSM (53)15 (28.8%)43(74.1)
GenderMale (117)25 (21.4)92 (78.6)0.011
Female (86)7 (8.1)79 (91.9)
Condom use during last sexual encounterYes (144)19(13.2)125(86.8)0.093
No (57)13(22.8)44 (77.2)
Have you missed any medicine in past 7 days?Yes (62)51 (82.3)11 (17.7)0.062
No (129)118(91.5)11(8.5)
Acceptance: How likely would you be to recommend PrEP to an HIV—partner?
Extremely Likely/LikelyExtremely Unlikely/ Unlikely/Unsurep-value
EducationFinished High School (134)122 (91.0)12 (9.0)0.170
Did not finish High School (72)61 (84.7)11 (15.3)
I believe PrEP will reduce the risk of HIV transmission to my partnerStrongly Agree/Agree (170)160 (94.1)10 (5.9)<0.001
Strongly Disagree/ Disagree/ Undecided (35)23 (65.7)12 (34.3)
Boldface indicates statistical significance (p<0.05)

Full article at:   http://goo.gl/bjjplk

Jesse Lawton Clark, Editor
1Drexel University College of Medicine, Philadelphia, PA, United States of America
2Department of Infectious Diseases and HIV Medicine, Drexel University College of Medicine, Philadelphia, PA, United States of America
3Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA, United States of America
David Geffen School of Medicine at UCLA, UNITED STATES
Competing Interests: The authors have declared that no competing interests exist.
Conceived and designed the experiments: EA ZS. Performed the experiments: JSJ. Analyzed the data: EG ES. Contributed reagents/materials/analysis tools: EA JSJ ZS EG ES. Wrote the paper: JSJ EA ZS EG ES.
¤Current address: AJ Drexel Autism Institute, Drexel University School of Public Health, Philadelphia, PA, United States of America
* E-mail: ude.lexerd@34jsJ




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