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Background: While STD treatment remains an important HIV prevention strategy, newer biomedical interventions such as HIV pre-exposure prophylaxis (PrEP) expand the package of prevention services available to those at highest risk of HIV acquisition. We assessed patient knowledge, attitudes and behavior related to PrEP in New York City (NYC) STD clinics.
Methods: We surveyed patients at two NYC public STD clinics. Eligible patients were NYC residents ≥18 years who reported any one of: sex with males (males only) (MSM); sex with MSM (females only); injection drug use, trading sex for money or drugs, or sex with an HIV-positive partner. The survey assessed: awareness of PrEP, prior use, willingness to take PrEP (PrEP acceptability), and willingness to participate in a proposed STD clinic-based PrEP program. Respondents watched a 3-minute educational PrEP video after completing awareness and use questions. Correlates of PrEP awareness were evaluated using bivariate methods.
Results: Of 389 respondents, 97% (374/389) were male (almost exclusively MSM), 50% (190/389) were non-white, and 56% (219/389) were <30 years. Less than half (155/ 389) were aware of PrEP; 0/155 had used it; 70% (269/389) reported being somewhat or very likely to take PrEP; 65% (253/388) would participate in an STD clinic-based PrEP program. PrEP awareness was not associated with age, race, education level, or employment status but was associated with household income between $40-59K (OR 2.05, p<0.05) and 2-4 STD clinic visits in the previous 12 months (OR 1.99, p<0.01). Prior PrEP awareness was not associated with PrEP acceptability.
Conclusions: Although prior knowledge of PrEP was limited, willingness to participate in an STD clinic-based PrEP program was high, indicating an opportunity to provide information and support to those at highest risk of acquiring HIV. Further examination of the feasibility and challenges of providing PrEP within the NYC STD clinic setting is needed.