HIV Risk Perception and Preexposure Prophylaxis Interest Among a Heterosexual Population Visiting a Sexually Transmitted Infection Clinic

Abstract

Low perception of HIV risk despite behaviors associated with increased risk is thought to be a contributing factor for a higher prevalence of HIV in blacks than other groups in the United States. We sought to determine HIV risk perception and its impact on safer sex practices and interest in preexposure prophylaxis (PrEP). From August 1 to October 31, 2010, an anonymous survey was conducted at a sexually transmitted infection clinic asking questions about demographics, risk behaviors, and PrEP interest. Participants were categorized into high-risk, moderate-risk, and low-risk groups according to predefined HIV risk characteristics. Only heterosexual high-risk participants were further assessed for their risk perception, condom use and PrEP interest. There were 494 participants; 63% male, 70% blacks, 88% heterosexual; 83% were categorized into the high-risk group. Of the 359 heterosexual high-risk participants, 301 (84%) perceived themselves at no or low-risk. Rates of consistent condom use with vaginal, oral, and anal sex were low (<20%) in this group despite high levels of knowledge about HIV transmission risks. Rates of condom use were not affected by risk perception. No interest in PrEP was associated with low education level (adjusted odds ratio 4.97; p=0.02) and low risk perception. These findings suggest that despite having knowledge about HIV transmission risks, the majority of high-risk participants did not recognize their risks and used condoms with low frequency. Low risk perception and low education level may impact PrEP interest. Enhanced interventions are needed to improve HIV risk perception, safer sex practices, and knowledge about PrEP.

Attitudes and Perceptions of Biomedical HIV Prevention Methods: Voices from Young Men Who Have Sex with Men

“…In another study with STD clinic attendees in Chicago, there was significant interest in PrEP (84% of the sample). When asked if PrEP would change their sexual behaviors, about one quarter reported they would use condoms less frequently and/or discontinue their use entirely; over half reported they would have the same number of sexual partners (Khawcharoenporn, Kendrick, & Smith, 2012). …”

Intimacy Motivations and Pre-exposure Prophylaxis (PrEP) Adoption Intentions Among HIV-Negative Men Who Have Sex with Men (MSM) in Romantic Relationships

“…To date, studies have focused almost exclusively on individual-level correlates of PrEP adoption intentions among high risk HIV-negative MSM, such as risk perception, risk behavior with outside sexual partners, and sociodemographic variables, such as older age and lower socioeconomic status (30-33). Due to the inherent risk of HIV transmission within HIV serodiscordant couples, qualitative studies have examined attitudes towards PrEP among MSM in HIV serodiscordant relationships and found high levels of PrEP adoption intentions (34, 35).…”

Perspectives on HIV Prevention Among Urban Black Women: A Potential Role for HIV Pre-Exposure Prophylaxis

“…Although studies have assessed PrEP acceptability among men who have sex with men, 21,22 men and women in international settings, [23][24][25][26] and high risk heterosexuals in the US, 27,28 there is a critical need to understand PrEP acceptability and product preferences among US black women, [29][30][31][32] given the high HIV incidence in this population. A national survey of adult women in the US found that African American women were more likely than white women to consider using oral PrEP and that cost, peer perspectives, and physician input would influence their decision making.…”