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Differences Between Groups of Pre-exposure Prophylaxis (PrEP) Using Couples in HIV-Negative/Unknown Relationships.
Steven A John1, Gabriel Robles2, Tyrel J Starks2,3,4
1Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI.
HIV pre-exposure prophylaxis (PrEP) use is higher among gay and bisexual men engaging in higher-risk sexual behaviors. Expanded PrEP uptake is crucial for partnered men who have sex with men.
Area of Science:
- Epidemiology
- Public Health
- Sexual Health
Background:
- Limited epidemiological data exists on HIV pre-exposure prophylaxis (PrEP) use within couples.
- Understanding PrEP utilization in dyads is essential for targeted prevention strategies.
Purpose of the Study:
- To investigate the characteristics and correlates of HIV pre-exposure prophylaxis (PrEP) uptake in serodiscordant and concordant couples among men who have sex with men (MSM).
- To examine the association between demographics, relationship dynamics, sexual behaviors, and dyadic PrEP use.
Main Methods:
- A nationwide online survey of HIV-negative/unknown MSM with HIV-negative/unknown partners in the US (n=3140) was conducted in 2017.
- Participants reported individual and partner PrEP status, relationship factors, condomless anal sex (CAS) with main and casual partners, STI diagnoses, and sexual positioning.
- Multinomial logistic regression models were used to analyze associations with dyadic PrEP use.
Main Results:
- PrEP use was reported by 3.2% (partner only), 5.7% (participant only), and 4.9% (both partners).
- Condomless anal sex (CAS) with main or casual partners and non-monogamous relationship structures were associated with increased dyadic PrEP use.
- Six-month bacterial sexually transmitted infection prevalence varied across PrEP use groups, ranging from 2.8% to 15.6%.
Conclusions:
- PrEP use in MSM couples often coincides with periods of increased risk behavior.
- Further interventions are necessary to enhance PrEP uptake among partnered gay, bisexual, and other men who have sex with men.
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