Dramatic increase in preexposure prophylaxis use among MSM in Washington state

Area of Science:

• Public Health
• Epidemiology
• HIV Prevention

Background:

• Pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy, but its uptake has historically been slow.
• Washington State has supportive insurance and drug assistance programs for PrEP.
• Assessing trends in PrEP awareness and use among key populations is crucial for public health initiatives.

Purpose of the Study:

• To evaluate trends in awareness and uptake of HIV pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) in Washington State.
• To identify factors associated with PrEP use in this population.

Main Methods:

• Serial cross-sectional surveys were conducted annually from 2009 to 2015 at the Seattle Pride Parade.
• A convenience sample of 2168 MSM residing in Washington State, who denied a history of HIV-positive tests, were analyzed.
• Descriptive statistics and multivariable regression models assessed the association between calendar year, HIV risk, and PrEP awareness/uptake.

Main Results:

• In 2015, 23% of high-risk MSM reported currently using PrEP, with overall ever-use increasing from 5% in 2012 to 31% in 2015.
• PrEP use remained low (1-3%) among lower-risk MSM.
• Awareness of PrEP increased significantly, reaching 86% among high-risk MSM and 58% among lower-risk MSM by 2015.
• PrEP use was strongly associated with later calendar years and elevated HIV risk.

Conclusions:

• PrEP awareness is high and use has rapidly increased among MSM in Seattle, Washington.
• These findings indicate that high levels of PrEP use are achievable in populations at high risk for HIV infection.
• Public health strategies and accessible programs can effectively drive PrEP adoption.