Truvada (tenofovir/emtricitabine) as pre-exposure prophylaxis (PrEP) use was already on its way to becoming entrenched among men who have sex with men in San Francisco in 2014, but not among younger or nonwhite MSM. Publishing their findings in Sexually Transmitted Infections, researchers analyzed data on 411 MSM in San Francisco, including 301 who reported being HIV negative during their participation in the 2014 National HIV Behavioral Surveillance (NHBS) study.
The researchers found that, on the whole, 64.1 percent of the HIV-negative MSM in San Francisco meet the U.S. Centers for Disease Control and Prevention (CDC) guidelines for taking PrEP, meaning that they are at significant risk for contracting HIV. Eighty percent of MSM 18 to 24 years old were eligible compared with 28.6 percent of those 55 and older. However, none of those in the younger age bracket who met the guidelines had taken PrEP within the previous 12 months, compared with 30 percent of those in the older age bracket.
A total of 9.2 percent MSM overall and 14.5 percent of those MSM who met the CDC guidelines were taking PrEP, indicating that higher risk HIV-negative MSM were more likely to be on Truvada for prevention.
Just 4.3 percent of the Latino MSM who met the CDC guidelines were taking PrEP, as were 7.1 percent of eligible Asian MSM, 7.7 of eligible black MSM and 22.9 percent of white men. This meant that eligible white MSM were five times more likely to be on PrEP compared with eligible Latino MSM and four times more likely than eligible nonwhite MSM overall to be on PrEP. The investigators found no relationship between PrEP use and education, income or health insurance status.
Forty-eight percent of the HIV-negative MSM said they were willing to take PrEP. The range of willingness broken down by race was narrow: between 43 percent and 54 percent.
The study authors concluded “these findings call attention to the need to further monitor the rollout and uptake of PrEP in communities of MSM where it is recommended. PrEP uptake efforts should continue to attempt to reach black and Latino MSM. If black and Latino MSM do not take up PrEP use while white men do, it is possible that a greater share of new HIV diagnoses may occur among men of color, exacerbating noted HIV disparities.”
To read the study abstract, click here.