Interest in Long-Acting PrEP by Methamphetamine Use Among Men Who Have Sex with Men in Four Western US Cities

Vanessa M McMahan1,2,3, Courtney Moreno4, Alia Al-Tayyib5

  • 1Harvard Medical School, Boston, MA, USA. Vanessa_McMahan@hphci.harvard.edu.

AIDS and Behavior
|February 12, 2026
PubMed

Insights

Interest in long-acting pre-exposure prophylaxis (PrEP) is high among men who have sex with men (MSM). Methamphetamine users showed similar interest and use but lower awareness of PrEP options.

Area of Science:

  • Public Health
  • Infectious Disease Prevention
  • Sexual Health

Background:

  • Methamphetamine use is a significant factor in HIV transmission among men who have sex with men (MSM).
  • Suboptimal adherence to daily oral pre-exposure prophylaxis (PrEP) is common among methamphetamine-using MSM.
  • Long-acting PrEP presents a potential alternative to daily oral PrEP.

Purpose of the Study:

  • To assess interest in long-acting PrEP among HIV-negative MSM.
  • To compare interest and PrEP awareness between methamphetamine users and non-users within this population.

Main Methods:

  • Analysis of data from the 2023 National HIV Behavioral Surveillance survey.
  • Inclusion of 1,450 HIV-negative MSM participants from four western cities.
  • Assessment of methamphetamine use in the past 12 months and interest in long-acting PrEP.

Main Results:

  • Two-thirds (68%) of participants expressed interest in long-acting PrEP.
  • No significant differences in interest or prior PrEP use were observed between methamphetamine users and non-users.
  • Participants unaware of PrEP were more likely to have used methamphetamine (20% vs. 7%).
  • Among interested individuals, biannual injection was the preferred method (47%).

Conclusions:

  • High interest in long-acting PrEP exists among MSM, including those who use methamphetamine.
  • Methamphetamine users demonstrated similar PrEP interest and use but lower awareness compared to non-users.
  • Targeted awareness campaigns may be needed for methamphetamine-using MSM regarding PrEP options.

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