title: Limited knowledge and use of HIV post- and pre-exposure prophylaxis among gay and bisexual men.
abstract: BACKGROUND
  Post-exposure prophylaxis (PEP) is currently recommended after certain high-risk exposures, and pre-exposure prophylaxis (PrEP) is undergoing evaluation in clinical trials. Media reports have suggested substantial levels of community PrEP use despite its unproven effectiveness.
  
  
  METHODS
  We conducted a cross-sectional survey of 1819 HIV-uninfected gay/bisexual men in California to assess PEP and PrEP awareness and use.
  
  
  RESULTS
  Overall, 47% reported PEP awareness and 4% ever used PEP. Men who were older than 25 years of age (odds ratio [OR] = 2.2, 95% confidence interval [CI]: 1.5 to 3.1), were white (OR = 2.2, 95% CI: 1.6 to 3.0), had an annual income >$100,000 (OR = 2.0, 95% CI: 1.2 to 3.4), self-identified as gay/homosexual (OR = 2.4, 95% CI: 1.4 to 4.3), and had unprotected anal sex (OR = 1.8, 95% CI: 1.3 to 2.3) or sex under the influence of a drug (OR = 2.0, 95% CI: 1.5 to 2.7) were more likely to be aware of PEP, whereas speed users (OR = 0.6, 95% CI: 0.4 to 0.9) were less likely to be aware of PEP. Only 16% reported PrEP awareness, and <1% ever used PrEP. Unprotected anal sex (OR = 1.6, 95% CI: 1.1 to 2.3) and sex under the influence of a drug (OR = 1.5, 95% CI: 1.0 to 2.2) were associated with PrEP awareness.
  
  
  CONCLUSIONS
  PEP awareness and use were modest and PrEP use was rare among gay/bisexual men in California. Although PrEP is not currently recommended, community education on the availability of PEP is suggested.
authors.affiliation: Department of Medicine, San Francisco Department of Public Health, San Francisco, CA, USA. albert.liu@fdph.org
authors.forename: Albert Y
authors.initials: AY
authors.lastname: Liu
authors.forename: Pravina V
authors.initials: PV
authors.lastname: Kittredge
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.forename: H Fisher
authors.initials: HF
authors.lastname: Raymond
authors.forename: Katherine
authors.initials: K
authors.lastname: Ahrens
authors.forename: Tim
authors.initials: T
authors.lastname: Matheson
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hecht
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Klausner
authors.forename: Susan P
authors.initials: SP
authors.lastname: Buchbinder
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001727:Bisexuality; D002140:California; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000517:prevention & control* / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D012309:Risk-Taking; D011795:Surveys and Questionnaires
chemical_list: D019380:Anti-HIV Agents