Limited knowledge and use of HIV post- and pre-exposure prophylaxis among gay and bisexual men.
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.
Liu
Albert Y
AY
Department of Medicine, San Francisco Department of Public Health, San Francisco, CA, USA. albert.liu@fdph.org
Kittredge
Pravina V
PV
Vittinghoff
Eric
E
Raymond
H Fisher
HF
Ahrens
Katherine
K
Matheson
Tim
T
Hecht
Jennifer
J
Klausner
Jeffrey D
JD
Buchbinder
Susan P
SP
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
D019380:Anti-HIV Agents