Demographic characteristics associated with the use of HIV pre-exposure prophylaxis (PrEP) in an urban, community health center

Abstract

Individuals who are at high risk of contracting HIV should have equitable access to preventive measures, such as pre-exposure prophylaxis (PrEP). We conducted a retrospective data extract from the electronic medical records of federally-qualified health centers in New York City from 2016 to 2018. Descriptive statistics are presented, stratified by those who have been prescribed PrEP and those who have not. We created a variable called “ever-female” which includes individuals assigned female at birth or who have ever identified as female. A chi-square test was performed to determine the statistical significance between variables as p < .05. A total of 9659 patients met inclusion criteria for the study. Patients who were prescribed PrEP were significantly associated with being white and never-female, with 38.2% of those prescribed PrEP identifying as white and 83.8% of those prescribed PrEP categorized as never-female. Patients of trans experience were 9.6% of the PrEP cohort and 1.5% of the never PrEP cohort (p < .001). Patients identifying as Black/African American made up 19.8% of patients prescribed PrEP and 49.8% of those never prescribed PrEP (p < .001). Patients with the lowest reported income composed 48.4% of those prescribed PrEP compared to 69.3% of patients who were never prescribed PrEP (p < .001). These findings indicate that key demographic categories may not be accessing PrEP as much as would be expected for their level of risk. Barriers to access of PrEP for women and other at-risk, under-represented populations should be further studied.

Avaliação do estigma relacionado ao uso de prep em homens que fazem sexo com homens (HSH) / Evaluation of the stigma related to the use of prep in men who have sex with men (MSM)

“…Aqueles participantes que não informaram suas faixas etárias corresponderam a 17,85% (5). Outros estudos identificaram uma maior proporção de usuários de PrEP nas faixas etárias de 36 a 45 anos de idade 15 ou como sendo superior a 50% nos indivíduos de 30 a 49 anos 16 .…”

Brief Report: HIV Pre-exposure Prophylaxis Prescribing in an Urban Safety-Net Health System

“…Foremost, the majority of prior studies in safety-net settings [25][26][27] included data from community health centers that were early adopters of PrEP and specialize in care for sexual and gender minorities. In addition, sexual and gender minorities were the majority of patients in prior studies [25][26][27][28][29] , with several studies including primarily non-Hispanic White individuals, for whom PrEP uptake has been highest. In contrast, although we were unable to identify gender identity or sexual orientation in our study population, our health system serves an urban population of primarily racial and ethnic minorities, and a minority of our study sample was non-Hispanic White.…”

Pathopolitics: Pathologies and Biopolitics of PrEP

“…On the other hand, today women represent only 11.4% of current PrEP consumers (no racial or ethnic data is provided) (Levin, 2017 ). Although Gilead claims a growing increase in PrEP uptake, a set of recent studies still point out significant racial and gendered disparities (Golub, 2018 ; Kuehn, 2018 ; Caponi et al, 2019 ; Jenness et al, 2019 ).…”