Racial/Ethnic Disparities in HIV Preexposure Prophylaxis Among Men Who Have Sex with Men - 23 Urban Areas, 2017

Abstract

In 2017, preliminary data show that gay, bisexual, and other men who have sex with men (MSM) accounted for 67% of new diagnoses of human immunodeficiency virus (HIV) infection, that MSM who inject drugs accounted for an additional 3%, and that African American/black (black) and Hispanic/Latino (Hispanic) MSM were disproportionately affected (1). During 2010-2015, racial/ethnic disparities in HIV incidence increased among MSM; in 2015, rates among black and Hispanic MSM were 10.5 and 4.9 times as high, respectively, as the rate among white MSM (compared with 9.2 and 3.8 times as high, respectively, in 2010) (2). Increased use of preexposure prophylaxis (PrEP), which reduces the risk for sexual acquisition of HIV infection by approximately 99% when taken daily as prescribed,* would help to reduce these disparities and support the Ending the HIV Epidemic: A Plan for America initiative^† (3). Although PrEP use has increased among all MSM since 2014 (4), racial/ethnic disparities in PrEP use could increase existing disparities in HIV incidence among MSM (5). To understand racial/ethnic disparities in PrEP awareness, discussion with a health care provider, and use (steps in the HIV PrEP continuum of care) (6), CDC analyzed 2017 National HIV Behavioral Surveillance (NHBS) data. Black and Hispanic MSM were significantly less likely than were white MSM to be aware of PrEP, to have discussed PrEP with a health care provider, or to have used PrEP within the past year. Among those who had discussed PrEP with a health care provider within the past year, 68% of white MSM, 62% of Hispanic MSM, and 55% of black MSM, reported PrEP use. Prevention efforts need to increase PrEP use among all MSM and target eliminating racial/ethnic disparities in PrEP use.^§.

FIGURE

Preexposure prophylaxis (PrEP) awareness, discussion, and use, by race/ethnicity, among men who have sex with men (MSM) with a likely indication for PrEP use (N = 4,056) — 23 urban areas, 2017 Abbreviations: HIV = human immunodeficiency virus; NHBS = National HIV Behavioral Surveillance. * Respondents with a negative NHBS HIV test result were asked “Preexposure prophylaxis, or PrEP, is an antiretroviral medicine, such as Truvada, taken for months or years by a person who is HIV-negative to reduce the risk of getting HIV. Before today, have you ever heard of PrEP?” ^† If respondent had heard of PrEP before today, he was asked “In the past 12 months, have you had a discussion with a health care provider about taking PrEP?” ^§ If respondent had heard of PrEP before today, he was asked “In the past 12 months, have you taken PrEP to reduce the risk of getting HIV?” ^¶ Men with a likely indication for PrEP included those who had 1) a negative NHBS HIV test result following the NHBS interview; 2) either multiple male sex partners or any male sex partner with HIV infection within the past year; and 3) either condomless anal sex or a bacterial sexually transmitted infection within the past year.