Evaluation of an Individual-Level Intervention to Increase Knowledge and the Likelihood of Use for PrEP: Results from a Pilot Study

Background:  HIV remains a major health and social problem nationwide. Since the early days of the epidemic, behavioral change strategies have been the hallmark of prevention efforts. Significant advances in biomedical interventions, however, are transforming the HIV prevention paradigm. PrEPUp! is an individual-level intervention designed to raise awareness and knowledge of PrEP among at-risk Black MSM, transgender male-to-female individuals and heterosexual men and women.

Methods:  The prospective, pre-post intervention pilot study was conducted between March and November 2013 in Dallas, Texas. The one-hour, facilitator-led, in-person education session, was delivered to Black MSM, transgender MTF and heterosexual men and women recruited through targeted community outreach by trained staff and peer referrals. Knowledge, attitudes, beliefs and likelihood of PrEP use based on subjective and normative beliefs were assessed using a 36-item questionnaire administered just prior to and immediately following the intervention. Dependent sample t-tests were used to compare pre- and post-test results.

Results:  Seventy-four individuals completed the PrEPUP! intervention.  Participants were largely women (63%) and Black (87%).  Statistically significant changes in overall PrEP knowledge were observed (n=69, p=.000).  There was a significant difference in the proportion of respondents who agreed they would use PrEP based on affordability at baseline (M=30%, SD=1.38) and post-intervention (M=41%, SD=1.42), (t=-2.076, p=.042).  Reports of intent to share information about PrEP were also greater post-intervention (M=70%, SD=1.09) compared to baseline (M=40%, SD=12.4), (t=-2.305, p=.025).  Changes in subjective norms based on the perceptions others may have towards the individual taking PrEP were greater post-intervention (M=59%, SD=1.01) compared to baseline (M=27%, SD=1.21), (t=-2.547, p=.013).

Conclusions:  This pilot study provides support for the effectiveness of educational interventions to increase knowledge while addressing subjective norms and beliefs about PrEP. While limited by a small sample size and implementation in one state, the study offers insight into addressing community normative beliefs and health literacy towards PrEP.