Willingness to Take, Use of, and Indications for Pre-exposure Prophylaxis Among Men Who Have Sex With Men - 20 US Cities, 2014

Brooke E. Hoots*, Teresa Finlayson, Lina Nerlander, Gabriela Paz-Bailey, Pascale Wortley, Jeff Todd, Kimi Sato, Colin Flynn, Danielle German, Dawn Fukuda, Rose Doherty, Chris Wittke, Nikhil Prachand, Nanette Benbow, Antonio D. Jimenez, Jonathon Poe, Shane Sheu, Alicia Novoa, Alia Al-Tayyib, Melanie MattsonVivian Griffin, Emily Higgins, Kathryn Macomber, Salma Khuwaja, Hafeez Rehman, Paige Padgett, Ekow Kwa Sey, Yingbo Ma, Marlene LaLota, John Mark Schacht, David Forrest, Bridget Anderson, Amber Sinclair, Lou Smith, William T. Robinson, Narquis Barak, Meagan C. Zarwell, Alan Neaigus, Kathleen H. Reilly, Barbara Bolden, Afework Wogayehu, Henry Godette, Kathleen A. Brady, Mark Shpaner, Jennifer Shinefeld, Lissa Bayang, Veronica Tovar-Moore, H. Fisher Raymond, Theresa Ick, Sandra Miranda De León, National HIV Behavioral Surveillance Study Group

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

165 Scopus citations


Background. Pre-exposure prophylaxis (PrEP) is an effective prevention tool for people at substantial risk of acquiring human immunodeficiency virus (HIV). To monitor the current state of PrEP use among men who have sex with men (MSM), we report on willingness to use PrEP and PrEP utilization. To assess whether the MSM subpopulations at highest risk for infection have indications for PrEP according to the 2014 clinical guidelines, we estimated indications for PrEP for MSM by demographics. Methods. We analyzed data from the 2014 cycle of the National HIV Behavioral Surveillance (NHBS) system among MSM who tested HIV negative in NHBS and were currently sexually active. Adjusted prevalence ratios and 95% confidence intervals were estimated from log-linked Poisson regression with generalized estimating equations to explore differences in willingness to take PrEP, PrEP use, and indications for PrEP. Results. Whereas over half of MSM said they were willing to take PrEP, only about 4% reported using PrEP. There was no difference in willingness to take PrEP between black and white MSM. PrEP use was higher among white compared with black MSM and among those with greater education and income levels. Young, black MSM were less likely to have indications for PrEP compared with young MSM of other races/ethnicities. Conclusions. Young, black MSM, despite being at high risk of HIV acquisition, may not have indications for PrEP under the current guidelines. Clinicians may need to consider other factors besides risk behaviors such as HIV incidence and prevalence in subgroups of their communities when considering prescribing PrEP.

Original languageEnglish (US)
Pages (from-to)672-677
Number of pages6
JournalClinical Infectious Diseases
Issue number5
StatePublished - Sep 1 2016


  • HIV
  • MSM
  • PrEP
  • United States
  • pre-exposure prophylaxis

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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