Background: People with opioid use disorder (OUD) are disproportionately burdened by HIV. The United States' Centers for Disease Control and Prevention (CDC) has issued guidelines for pre-exposure prophylaxis (PrEP) indication. We know little about PrEP for people receiving medication for OUD. The objective of this study is to report PrEP indication, awareness, and uptake in patients engaged in outpatient OUD treatment with buprenorphine.
Methods: Adult patients (n = 137) receiving buprenorphine for OUD at an outpatient substance use disorder treatment clinic completed a cross-sectional survey between July and September 2019. The study determined PrEP indication by 2017 CDC criteria. PrEP awareness and uptake were self-reported. The study assessed statistical differences in PrEP indicators by Pearson's χ2 and Fisher's exact.
Results: Nearly three-quarters (73.7%, n = 101) of the study sample met CDC criteria for PrEP-indication based on past-year risk behaviors. Ninety-five percent of these participants reported inconsistent condom use, 21.0% engaged in commercial sex, 9.0% shared injection equipment, 8.9% reported a recent bacterial STI, and 4.0% had an HIV+ sexual partner. Of PrEP indicated participants (n = 101), 19 had heard of PrEP prior to the survey, but only 1 participant reported past-year PrEP use.
Conclusions: Among a clinical population of people receiving buprenorphine for OUD, HIV risk behaviors were common, yet PrEP awareness and uptake were low. People engaged in treatment for OUD remain at high risk for HIV and are a priority population for PrEP. In light of the current opioid crisis, more research is needed to guide the integration of comprehensive HIV prevention into outpatient opioid treatment centers.
Keywords: Buprenorphine; HIV prevention; Opioid use disorder; PrEP; Substance use disorder treatment.
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