Development of a targeted educational intervention to increase pre-exposure prophylaxis uptake among cisgender men and transgender individuals who have sex with men and use methamphetamine in Seattle (WA, USA)

Sex Health. 2019 Apr;16(2):139-147. doi: 10.1071/SH18060.


Background Cisgender men and transgender individuals who have sex with men (MSM/TG) and use methamphetamine are at elevated risk for HIV and have had limited pre-exposure prophylaxis (PrEP) uptake. The aim of this study was to quantify the knowledge and use of PrEP, identify barriers to PrEP use, and develop a targeted educational campaign to promote PrEP among MSM/TG who use methamphetamine.

Methods: We conducted three consultations with peer educators of Project Needle and Sex Education Outreach Network (NEON) to develop and disseminate educational materials. We surveyed the peers' HIV-negative contacts before and after this work to explore knowledge and opinions about PrEP and to assess the effect of our materials.

Results: There were 221 respondents at baseline (August 2016) and 100 at follow-up (April-May 2017). At baseline, nearly all participants had 'heard of PrEP' (96%) and were insured (97%). However, only 3% had ever used PrEP. Peers suggested educational cards that included a definition of PrEP, adherence tips and that PrEP does not prevent other sexually transmissible infections. Peers distributed approximately 2560 educational cards. At follow-up, approximately half the respondents (53%) had seen the cards, and those who did reported significantly more agreement with the majority of the card messages about PrEP. Significantly more participants reported ever receiving PrEP at follow-up (21%; P<0.001). There was a trend between seeing the cards and PrEP use (P=0.053).

Conclusions: Although we cannot be certain that the effect was due to our intervention, a greater number of the peers' contacts reported receiving PrEP at follow-up, and those who saw our materials were more likely to agree with factual statements about PrEP. There is continued need for PrEP education for MSM/TG who use methamphetamine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Amphetamine-Related Disorders*
  • Female
  • HIV Infections / prevention & control*
  • Harm Reduction
  • Health Education / methods
  • Health Promotion / methods*
  • Humans
  • Male
  • Methamphetamine
  • Peer Group*
  • Pre-Exposure Prophylaxis*
  • Sexual and Gender Minorities / education
  • Transgender Persons / education*


  • Methamphetamine