Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA.
HIV/STD Program, Public Health - Seattle and King County, Seattle, Washington, USA.
Subst Use Misuse. 2022;57(3):337-343. doi: 10.1080/10826084.2021.2012688. Epub 2021 Dec 13.
HIV pre-exposure prophylaxis (PrEP) is safe and effective for use in people who inject drugs (PWID), but PrEP is underutilized in this population. We assessed awareness of PrEP and correlates of interest in PrEP among PWID in Seattle, Washington.
This study analyzed data from a 2019 survey of PWID at 3 Seattle-area syringe service programs (SSPs). We used descriptive statistics to compare PrEP-aware and unaware PWID and multivariable Poisson regression with robust standard errors to estimate adjusted prevalence ratios (APR) for interest in PrEP.
Among 348 HIV-negative PWID, ≤1% were currently taking PrEP, 51% were PrEP aware and 46% were interested in PrEP. Interest in PrEP was inversely associated with prior PrEP awareness (APR 0.58, 95% CI 0.45 - 0.74); however, interest in PrEP was high among PWID meeting pre-specified risk criteria for HIV (APR 1.41, 95% CI 1.06 - 1.88).
Our results suggest increasing awareness of PrEP may not be sufficient to promote PrEP uptake among PWID, and further efforts are needed to understand perceptions of risk for HIV, determinants of PrEP use, and to investigate successful strategies for PrEP implementation and delivery in this marginalized population.
Supplemental data for this article is available online at https://doi.org/10.1080/10826084.2021.2012688 .
暴露前预防（PrEP）在注射吸毒者（PWID）中使用安全且有效，但该人群中 PrEP 的使用率较低。我们评估了西雅图地区 3 个注射吸毒者美沙酮维持治疗点中 PrEP 的知晓率以及与 PrEP 相关的兴趣。
本研究分析了 2019 年对西雅图地区 3 个美沙酮维持治疗点的注射吸毒者的调查数据。我们使用描述性统计方法比较了 PrEP 知晓者和不知晓者的特征，使用多变量泊松回归分析（robust standard errors），并估计了对 PrEP 感兴趣的调整后流行率比（APR）。
在 348 名 HIV 阴性的注射吸毒者中，≤1%的人正在服用 PrEP，51%的人知晓 PrEP，46%的人对 PrEP 感兴趣。对 PrEP 的兴趣与之前的 PrEP 知晓率呈负相关（APR 0.58，95%CI 0.45-0.74）；然而，符合 HIV 风险标准的 PWID 对 PrEP 很感兴趣（APR 1.41，95%CI 1.06-1.88）。
我们的研究结果表明，增加对 PrEP 的认识可能不足以促进 PWID 对 PrEP 的接受，需要进一步努力了解对 HIV 的风险认知、PrEP 使用的决定因素，并研究在这一边缘化人群中实施和提供 PrEP 的成功策略。
本文补充资料可在 https://doi.org/10.1080/10826084.2021.2012688 在线获取。
