Rory Meyers College of Nursing, New York University, New York, NY, United States; Center for Drug Use and HIV/HCV Research, New York, NY, United States.
Department of Gender, Sexuality, and Women's Studies, Virginia Commonwealth University, Richmond, VA, United States.
Int J Drug Policy. 2020 Mar;77:102671. doi: 10.1016/j.drugpo.2020.102671. Epub 2020 Feb 21.
Male persons who inject drugs (male PWID) are at heightened risk for HIV, particularly if they also have sex with men. Pre-exposure prophylaxis (PrEP) could aid in HIV prevention for this population, but PrEP awareness within different sexual identities among male PWID is not well-understood. We report factors associated with greater awareness among male PWID to identify efficient means of awareness dissemination.
Data from the 2015 National HIV Behavioral Surveillance (NHBS) system cycle on injection drug use collected in New York City (NYC) were used. Bivariable analyses, using chi-squared statistics, were conducted to examine correlates of awareness of PrEP with socio-demographic, behavioral, and health care variables. Log-linked Poisson regression with robust standard errors was used to estimate adjusted prevalence ratios and determine differences in awareness of PrEP.
Among a sample of 332 male PWID (i.e., PWID who identified as male, not transgender) we find awareness of PrEP to be low (23%) among male PWID despite 68% reporting condomless vaginal/anal sex and 32% reporting injection equipment sharing in the last twelve months. Multivariable analysis found greater PrEP awareness associated with gay or bisexual identity (aPR: 2.77, 95% CI: 1.81-4.24) and having a conversation about HIV prevention at a syringe exchange program (SEP) (aPR: 2.71, 95% CI: 1.87-3.94) to be associated with increased PrEP awareness.
We found low rates of PrEP awareness among male PWID. However, our findings provide insight into information diffusion that can be utilized to increase PrEP awareness among male PWID and among all PWID. We suggest that gay and bisexual social networks and syringe exchange programs are diffusing PrEP awareness among male PWID and can be harnessed to increase PrEP awareness among male PWID.
男性注射吸毒者（男 PWID）感染 HIV 的风险较高，尤其是如果他们还与男性发生性行为。暴露前预防（PrEP）可以帮助该人群预防 HIV，但男 PWID 不同性身份对 PrEP 的认识尚不清楚。我们报告了与男 PWID 更高认识率相关的因素，以确定有效的意识传播手段。
使用 2015 年在纽约市（NYC）收集的国家 HIV 行为监测（NHBS）系统周期中关于注射毒品使用的数据。使用卡方检验进行单变量分析，以检查 PrEP 意识与社会人口统计学、行为和医疗保健变量的相关性。使用对数链接泊松回归和稳健标准误差来估计调整后的流行率比，并确定 PrEP 意识差异。
在 332 名男 PWID（即，自我认同为男性，非跨性别者）的样本中，我们发现尽管 68%的人报告在过去 12 个月内发生过无保护的阴道/肛门性行为，32%的人报告过共用注射设备，但男 PWID 对 PrEP 的认识率仍然很低（23%）。多变量分析发现，同性恋或双性恋身份（调整后的流行率比：2.77，95%置信区间：1.81-4.24）和在注射器交换项目（SEP）上讨论 HIV 预防问题（调整后的流行率比：2.71，95%置信区间：1.87-3.94）与更高的 PrEP 意识相关。
我们发现男 PWID 对 PrEP 的认识率较低。然而，我们的研究结果提供了有关信息传播的见解，可用于提高男 PWID 和所有 PWID 对 PrEP 的认识率。我们建议，同性恋和双性恋社交网络和注射器交换项目正在传播男 PWID 对 PrEP 的认识，并可以利用这些网络和项目来提高男 PWID 对 PrEP 的认识率。
