187. E-Volution- A Two Way Text Messaging Intervention To Support Young People With HIV Achieve Health And Wellbeing

Abstract

Purpose: HIV pre-exposure prophylaxis (PrEP) is a once-daily pill that can reduce infection risk by up to 99% and empower users to promote their sexual health and psychological well-being. Among adolescents and young adults (AYAs) who are racial/ethnic and sexual minorities, uptake of PrEP has been poor and understudied in real-world settings such as pediatric/adolescent primary care clinics. The objective of this study is to elucidate barriers and facilitators to PrEP initiation among at-risk AYA attending an urban U.S. primary care clinic. Methods: Sexually-active AYAs who were ever eligible for HIV testing were invited to complete an anonymous 19-question survey about PrEP awareness, interest in taking PrEP after learning about the "daily pill that can protect against HIV," and intention to discuss PrEP with a peer navigator that day. Bivariate and multivariable Poisson regressions were conducted to gauge response differences by age (14-19 or 20-24), gender (male or female), sexuality (heterosexual or gay/bisexual/lesbian), clinic visit type (primary care, acute, or STI testing/treatment), and PrEP awareness (aware or not). Data were analyzed using STATA 15 Ò . Results: 73 AYAs were surveyed. Most respondents were 14-19 (63%), African-American (97%), female (70%), heterosexual (84%), and visiting for primary care (57%). One-fourth were aware of PrEP and 58% (n¼42) reported they were interested in taking PrEP. The most common reasons for interest in PrEP included lowering HIV risk (95%) and reducing anxiety about sex (26%). The most common reasons for not being interested included perceiving low HIV risk (52%), believing they could not take PrEP every day (35%), knowing too little about PrEP (35%), and being concerned about side effects (29%). Among those who were interested in PrEP, 43% (n¼16) indicated that they were willing to discuss PrEP with a navigator, however few (n¼3) ultimately did. Multivariable Poisson regression analysis indicated that 14e19-year-olds had nearly 3-times greater likelihood of PrEP awareness compared to 20e24-year-olds (IRR¼2.9, 95% CI¼1.1e7.6, p¼0.03), and that gay/bisexual/lesbian respondents had nearly 4-times greater likelihood of awareness compared to heterosexual respondents (IRR¼3.6, 95% CI¼1.7e7.5, p<0.01). AYAs aged 14-19 had 2-times greater likelihood of being interested in taking PrEP than their 20-24-year-old peers (IRR¼2.3, 95% CI¼1.1e 4.8, p¼0.02). No characteristics were associated with meeting a PrEP provider.