US: Only 4% of sexually active gay and bisexual men in the U.S. use pre-exposure prophylaxis (PrEP)

For immediate release
September 11, 2018

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25% of young sexually active gay and bisexual men have never been tested for HIV

The Williams Institute at UCLA School of Law finds that only 4% of sexually active gay and bisexual men in the United States use Truvada as pre-exposure prophylaxis (PrEP), which the Centers for Disease Control and Prevention regards as a highly effective tool to prevent the transmission of HIV.

In addition, researchers found that most sexually active gay and bisexual men aged 18-25 are not tested for HIV annually, as recommended by the CDC, and 25% of young men have never been tested.

“Our findings suggest that health education efforts are not adequately reaching sizable groups of men at risk for HIV infection,” said the study’s principal investigator Ilan H. Meyer, Distinguished Senior Public Policy Scholar at the Williams Institute. “It is alarming that high-risk populations of men who are sexually active with same-sex partners are not being tested or taking advantage of treatment advances to prevent the spread of HIV.”

This is the first study to report on estimates of HIV testing and use of PrEP among gay and bisexual men using a national probability sample in the United States. In the study, researchers examined gay and bisexual men in three age groups: young (18-25), middle (34-41) and older (52-59).

Key findings

PrEP Use

  • Only 4% of sexually active gay/bisexual men of all age groups use PrEP.

  • Visiting an LGBT health clinic and searching online for LGBT resources were associated with greater likelihood of PrEP use.

  • Slightly more than half (52%) of young sexually active gay and bisexual men were familiar with PrEP as HIV prevention, compared with 79% of men aged 34-41.

  • Bisexual and non-urban men were less familiar with PrEP compared with gay-identified and urban men.

  • Most (68%) men who were familiar with PrEP as HIV prevention had a positive attitude toward PrEP use—despite the low level of usage.

HIV Testing

  • One quarter (25%) of young gay and bisexual men had never tested for HIV in their lives, compared to approximately 8% of the middle and older groups of men.

  • 45% of young sexually active gay and bisexual men had tested for HIV at least annually, compared with 59% of men aged 34-41 and 36% of those aged 52-59.

  • Black gay/bisexual men were more likely than White men to meet recommendations for HIV testing, which may be due to recent efforts to target Black men for HIV testing.

  • Visiting an LGBT health clinic and being out as gay or bisexual to health care providers were associated with greater likelihood of HIV testing.

“The extremely low rate of PrEP use, while not surprising given barriers to access in various parts of the country, is disappointing,” said lead author Phillip L. Hammack, Ph.D., Professor of Psychology at the University of California, Santa Cruz. “I worry especially about younger men who didn’t grow up with the concerns of HIV that men of older generations did. The low rate of HIV testing probably reflects a degree of complacency and cultural amnesia about AIDS.”

“In the early days of the AIDS epidemic, gay and bisexual men had to rely on LGBT community sources to receive information about HIV prevention,” said Meyer. “Our findings suggest that contact with LGBT community resources—health clinics and online information—still serves an important role in HIV prevention.”

Truveda is currently the only FDA-approved form of PrEP.

The report, “HIV Testing and Pre-Exposure Prophylaxis (PrEP) Use, Familiarity, and Attitudes among Gay and Bisexual Men in the United States: A National Probability Sample of Three Birth Cohorts” appears in PLOS ONE and is co-authored by Phillip L. Hammack, Ph.D., Professor of Psychology at the University of California, Santa Cruz, Ilan H. Meyer, Ph.D., Distinguished Senior Public Policy Scholar at the Williams Institute, Evan A. Krueger, MPH, Research Coordinator at the Williams Institute, Marguerita Lightfoot, Ph.D., Professor of Medicine at the University of California, San Francisco, and David M. Frost, Ph.D., Senior Lecturer at University College London.

Research reported in this article is part of the Generations Study, supported by the National Institute of Child Health and Human Development (NICHD) of the National Institutes of Health, under award number R01HD078526. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Generations investigators are Ilan H. Meyer, Ph.D., (PI, UCLA); David M. Frost, Ph.D., (University College London); Phillip L. Hammack, Ph.D., (UCSC); Marguerita Lightfoot, Ph.D., (UCSF); Stephen T. Russell, Ph.D. (University of Texas, Austin) and Bianca D.M. Wilson, Ph.D., (UCLA) Co-Investigators are listed alphabetically. See more via Williams Institute

HIV testing and pre-exposure prophylaxis (PrEP) use, familiarity, and attitudes among gay and bisexual men in the United States: A national probability sample of three birth cohorts

Abstract

This study examined HIV testing and use, familiarity, and attitudes toward pre-exposure prophylaxis (PrEP) among HIV-negative gay and bisexual men in the United States. A national probability sample (N = 470) of three age cohorts (18–25, 34–41, and 52–59 years) completed a survey between March, 2016 and March, 2017. Most men did not meet CDC recommendations for HIV testing, and 25.2% of men in the younger cohort had never tested. Only 4.1% used PrEP across cohorts. Visiting an LGBT clinic and searching for LGBT resources online were associated with PrEP use. Men in the middle cohort were more familiar with PrEP (79%) than men in the younger (52%) and older (57%) cohorts. Bisexual and non-urban men were less familiar with PrEP. Attitudes were positive among most men (68.4%) familiar with PrEP. Findings suggest that most men potentially at risk for HIV do not meet CDC guidelines for testing, and PrEP use continues to be minimal. Efforts to educate gay and bisexual men about HIV risk and prevention need to be reinvigorated and expanded to include non-gay-identified and non-urban men.

Read more via PLOS