Mental Health, Social Influences, and HIV Pre-exposure Prophylaxis (PrEP) Utilization Among Men and Transgender Individuals Screening for HIV Prevention Trials

AIDS Behav. 2021 Feb;25(2):524-531. doi: 10.1007/s10461-020-03004-y.


The effects of mental health comorbidities and social support on the HIV pre-exposure prophylaxis (PrEP) care continuum are unknown. We conducted a cross-sectional study of men and transgender individuals, ≥ 18 years-old, with ≥ 2 male or transgender partners, or recent condomless anal intercourse. Surveys assessed demographics, mental health treatment, depressive symptomatology, social support, and PrEP-related social contacts. Logistic regression assessed associations between these factors and PrEP uptake and persistence. Participants (n = 247) were 89% cis-male and 46% African-American. Median age was 27 (IQR:23-33). Thirty-seven percent had ever used PrEP, of whom 18% discontinued use. High depressive symptomology was identified in 11% and 9% were receiving mental health treatment. There were no significant associations between depressive symptoms or mental health treatment on the odds of PrEP uptake or discontinuation. Each additional PrEP contact conferred a greater odds of uptake (aOR:1.24, 95% CI: 1.09-1.42). Network-level targets may produce fruitful interventions to increase PrEP uptake.

Keywords: Depression; HIV; Pre-exposure prophylaxis; Social networks.

MeSH terms

  • Adult
  • Anti-HIV Agents* / therapeutic use
  • Cross-Sectional Studies
  • HIV Infections* / drug therapy
  • HIV Infections* / prevention & control
  • Homosexuality, Male
  • Humans
  • Male
  • Mental Health*
  • Pre-Exposure Prophylaxis*
  • Transgender Persons*


  • Anti-HIV Agents