Knowledge and Barriers to HIV Pre-exposure Prophylaxis in Southern California

Despite the proven effectiveness of human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP), its use remains low in high-incidence areas. This study examined knowledge and barriers to PrEP among individuals at risk in Southern California. From September 2022 to April 2023, we recruited adult men who have sex with men, residing in San Bernardino and Riverside counties, who were not living with HIV and not using PrEP. Recruitment occurred through targeted online advertisements and clinic-distributed materials. Statistical analyses explored associations between demographic factors and barriers to PrEP. While 81% had heard of PrEP, nearly half were unaware of HIV testing requirements or of its availability for uninsured individuals. Uninsured participants were significantly less comfortable discussing sexual health with providers (OR: 0.19, 95% CI [0.05, 0.68]). Addressing misinformation, reducing provider stigma, and expanding access for uninsured individuals are essential for increasing PrEP use.