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Human Immunodeficiency Virus/Sexually Transmitted Infection Counseling and Testing Services Received by Gay and Bisexual Men Using Preexposure Prophylaxis at Their Last PrEP Care Visit

Parsons, Jeffrey T., PhD*†‡; John, Steven A., PhD, MPH*; Whitfield, Thomas H.F., MA*†; Cienfuegos-Szalay, Jorge, MPH*†; Grov, Christian, PhD, MPH§¶

doi: 10.1097/OLQ.0000000000000880
Original Studies

Background Preexposure prophylaxis (PrEP) reduces risk of human immunodeficiency virus infection for many gay and bisexual men (GBM); however, bacterial sexually transmitted infections associated with decreasing condom use among users is of concern. Center for Disease Control and Prevention's guidelines for PrEP use recommend bacterial sexually transmitted infection screening every 6 months. We sought to investigate comprehensive PrEP care, defined as: (1) discussion of sexual behavior, (2) blood sample, (3) urine sample, (4) rectal sample (rectal swab), and (5) throat sample (throat swab), provided at the user's last PrEP appointment.

Methods The PrEP-using GBM in New York City (n = 104) were asked about their last PrEP care visit. We examined associations of demographics (age, race/ethnicity, and education), recent number of condomless anal sex events, time on PrEP, and health care provider type on receiving comprehensive care at last visit using fully adjusted binary logistic regression.

Results At their last visit, nearly all men (94%) gave blood for testing, 88% provided a urine sample, and 77% discussed sexual behavior with their provider. However, only 51% reported having a rectal swab, and 48% an oral swab. Only 32% of men received comprehensive PrEP care at their last PrEP visit. Odds of receiving comprehensive care were significantly higher among younger men, men with a bachelor's degree or more education, and those who reported more condomless anal sex.

Conclusions Less than one third of GBM received comprehensive human immunodeficiency virus/sexually transmitted infection counseling and testing at their last visit. These findings indicate further efforts are needed to prepare health care providers for prescribing and managing patients on PrEP.

Less than one third of gay and bisexual men using preexposure prophylaxis in New York City received comprehensive human immunodeficiency virus/sexually transmitted infection counseling and testing at their last preexposure prophylaxis care visit.

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

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

Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY;

§Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy; and

The CUNY Institute for Implementation Science in Population Health, New York, NY

Acknowledgments: Funding support for the PrEP & Me study and authors of this manuscript came from the National Institute on Drug Abuse (NIDA) (R21-DA039019, PI: Grov), National Institute of Mental Health (F31-MH116874, PI: Whitfield), and National Institute of Child Health and Human Development (U19-HD089975, MPIs: Naar and Parsons). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health (NIH). The authors would like to acknowledge the contributions of the other members of the PrEP & Me study team (H. Jonathon Rendina, Mark Pawson, Brian Salfas, Chloe Mirzayi, Juan Castiblanco, and Ruben Jimenez) and other staff from the Center for HIV/AIDS Educational Studies and Training (Chris Hietikko, Tina Koo, Carlos Ponton, and Paula Bertone). Finally, we thank Shoshana Kahana at NIDA and all of our participants who participated in PrEP & Me. NIH and the affiliated institutes had no role in the production of this manuscript nor necessarily endorses its findings.

Conflicts of Interest: None declared.

Sources of Funding: Funding support for the study was provided by the National Institute on Drug Abuse (R21-DA039019, PI: Grov). Funding support for T.H.F.W. came from the National Institute of Mental Health (F31-MH116874, PI: Whitfield). Funding support for J.T.P., S.A.J., and J.C.-S. came from the National Institute of Child Health and Human Development (U19-HD089975, MPIs: Naar and Parsons).

Correspondence: Christian Grov, PhD, MPH, City University of New York School of Public Health, 55 West 125th St, New York, NY 10027. E-mail: cgrov@sph.cuny.edu.

Received for publication March 27, 2018, and accepted June 20, 2018.

© Copyright 2018 American Sexually Transmitted Diseases Association