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Differences Between Groups of Pre-exposure Prophylaxis (PrEP) Using Couples in HIV-Negative/Unknown Relationships

John, Steven A. PhD, MPHa; Robles, Gabriel PhD, MSWb; Starks, Tyrel J. PhDb,c,d; Rendina, H. Jonathon PhD, MPHb,c,d

JAIDS Journal of Acquired Immune Deficiency Syndromes: August 1, 2019 - Volume 81 - Issue 4 - p 419–428
doi: 10.1097/QAI.0000000000002058
Prevention Research
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Background: Epidemiology research is limited on the characteristics of HIV pre-exposure prophylaxis (PrEP) using couples.

Setting: US nationwide sample recruited online in 2017.

Methods: HIV negative/unknown gay, bisexual, and other men who have sex with men with HIV negative/unknown partners (n = 3140) were asked about individual and main partner PrEP uptake. Men were coded into the following 5 groups: (1) neither participant nor partner on PrEP, (2) partner only on PrEP, (3) participant only on PrEP, (4) both on PrEP, and (5) unknown partner PrEP use. We examined associations of demographics, relationship factors, condomless anal sex (CAS) with main and causal partners, bacterial sexually transmitted infection diagnoses, and sexual positioning with reported dyadic PrEP use using fully adjusted multinomial logistic regressions.

Results: PrEP use was 3.2% for the partner only, 5.7% for the participant only, and 4.9% for both the participant and partner; 5.6% reported not knowing their partner's PrEP use status. Men who reported any CAS with their main partner or any CAS with male casual partners were both more likely to be classified in the dyadic PrEP use group compared with the neither on PrEP group. Compared with monogamous, men in open arrangements were more likely to be classified in each of the 3 PrEP groups compared with the neither on PrEP group. Six-month bacterial sexually transmitted infection prevalence was 2.8%, 8.1%, 8.3%, 15.6%, and 4.0% for the 5 groups, respectively.

Conclusions: PrEP use occurred during times of higher risk behavior engagement, but further efforts are needed to expand PrEP use to more partnered gay, bisexual, and other men who have sex with men.

aCenter for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI;

bCenter for HIV/AIDS Educational Studies and Training, Hunter College of the City University of New York (CUNY), New York, NY;

cHealth Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY; and

dDepartment of Psychology, Hunter College of the City University of New York (CUNY), New York, NY.

Correspondence to: H. Jonathon Rendina, PhD, MPH, Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Avenue, Room N611, New York, NY 10065 (e-mail: hrendina@hunter.cuny.edu).

S.A.J. was supported by the Center for AIDS Intervention Research (CAIR) and the National Institute of Mental Health (P30-MH052776, PI: Jeffrey A. Kelly). G.R. received support from the National Institute on Drug Abuse (R01-DA045613-01S1, PI: T.J.S., Awardee: G.R.). H.J.R. was supported in part by a career development award from the National Institute on Drug Abuse (K01-DA039060; PI: H.J.R.). Data collection for this paper was supported in part by the Fordham HIV and Drug Abuse Prevention Research Ethics Training Institute (RETI), a training grant sponsored by the National Institute on Drug Abuse (R25-DA031608, PI: Celia B. Fisher). The authors also acknowledge the generous funding provided by the offices of the President, the Provost, and the Dean of Arts and Sciences of Hunter College, CUNY; additional support was also provided by Hunter College's Center for HIV/AIDS Educational Studies and Training (CHEST). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, Fordham RETI, Medical College of Wisconsin, or Hunter College, CUNY. The authors acknowledge the contributions of Dr. Jeffrey T. Parsons, Dr. Celia B. Fisher, Dr. Brian Mustanski, Dr. Brenda Curtis, and the Center for HIV/AIDS Educational Studies and Training Research Team, in particular those who played important roles in the implementation of the project and this manuscript: Ruben Jimenez, Scott Jones, Jonathan Lopez-Matos, and Chloe Mirzayi.

Presented in part at International Association of Providers of AIDS Care (IAPAC) Conference; June 8–10, 2018; Miami, FL.

The authors have no conflicts of interest to disclose.

Received November 01, 2018

Accepted March 18, 2019

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