Eustaquio Patrick C, Burnett Janet, Prejean Joseph, Chapin-Bardales Johanna, Cha Susan
Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA.
AIDS. 2024 Dec 1;38(15):2086-2092. doi: 10.1097/QAD.0000000000004005. Epub 2024 Sep 2.
Men who inject drugs who have sex with men (MWIDSM) may acquire HIV through injecting drugs or sex. Interventions to increase awareness of HIV preexposure prophylaxis (PrEP) have focused on gay/bisexual MSM and may not be reaching heterosexual-identifying men or people who inject drugs (PWID). We explored changes in PrEP awareness and use among MWIDSM from 2018 to 2022 by sexual identity.
We used data from the 2018 and 2022 National HIV Behavioral Surveillance among PWID recruited via respondent-driven sampling in 19 urban areas in the US. We examined changes in PrEP awareness and use over time by sexual identity among HIV-negative men who inject drugs and who had sex with another man in the past 12 months using log-linked Poisson regression models with robust standard errors with an interaction term between year and sexual identity.
Among 758 HIV-negative MWIDSM (463 in 2018; 295 in 2022), nearly all sample participants were likely indicated for PrEP (94.2 and 92.9%, respectively). PrEP awareness increased from 2018 to 2022 among gay/bisexual-identifying MWIDSM [45.5 to 65.5%; aPR = 1.49, 95% confidence interval (95% CI) = 1.30-1.70] but remained stable for heterosexual-identifying MWIDSM (39.4 to 40.8%; aPR = 1.01, 95% CI 0.75-1.36). PrEP use remained low among all MWIDSM (2.5 to 7.7%, among heterosexually identifying; 15.3 to 10.2% among gay/bisexual-identifying).
PrEP awareness increased among gay/bisexual-identifying MWIDSM but not among heterosexual-identifying. PrEP use was low for all MWIDSM. Public health initiatives catered to MWIDSM should focus on improved campaigns and expanding PrEP accessibility in existing healthcare, harm reduction, and social services.
与男性发生性关系的注射毒品者（MWIDSM）可能通过注射毒品或性行为感染艾滋病毒。提高艾滋病毒暴露前预防（PrEP）意识的干预措施主要集中在男同性恋/双性恋男性中，可能未覆盖自我认定为异性恋的男性或注射毒品者（PWID）。我们按性取向探讨了2018年至2022年期间MWIDSM中PrEP意识和使用情况的变化。
我们使用了2018年和2022年在美国19个城市通过应答者驱动抽样招募的注射毒品者全国艾滋病毒行为监测数据。我们使用对数链接泊松回归模型和稳健标准误差，并设置年份和性取向之间的交互项，研究了在过去12个月内注射毒品且与另一名男性发生过性行为的艾滋病毒阴性男性中，PrEP意识和使用情况随时间按性取向的变化。
在758名艾滋病毒阴性的MWIDSM中（2018年463名；2022年295名），几乎所有样本参与者都可能适合使用PrEP（分别为94.2%和92.9%）。2018年至2022年期间，自我认定为男同性恋/双性恋的MWIDSM中PrEP意识有所提高[从45.
