Post-Exposure Prophylaxis and Methamphetamine Use among Young Sexual Minority Men: The P18 Cohort Study

Abstract

Methamphetamine use is associated with increased risk of HIV infection among young sexual minority men (SMM). Post-exposure prophylaxis (PEP) is an effective strategy for individuals who are exposed to HIV, but there is limited research about PEP use among young SMM and its relationship with methamphetamine use. This study analyzes the association between ever PEP use and recent methamphetamine use among young SMM in New York City, using cross-sectional data from the P18 Cohort Study (n = 429). Multivariable logistic regression models were used to assess the association between methamphetamine use and ever PEP use. Compared with those who had not used methamphetamine in the last 6 months, young SMM who did use methamphetamine were significantly more likely to have ever used PEP (AOR = 6.07, 95% CI: 2.10–16.86). Young SMM who had ever used PrEP had 16 times higher odds of ever using PEP (AOR = 16, 95% CI: 7.41–35.95). Those who completed bachelor’s degrees were 61% less likely to have ever used PEP (AOR = 0.39, 95% CI: 0.17–0.88). These data suggest that methamphetamine use could increase the risk of HIV infection, highlighting the critical need to target interventions for young SMM who use methamphetamine and are more likely to engage in unprotected intercourse.

The Use of HIV Pre- and Postexposure Prophylaxis Among a Web-Based Sample of HIV-Negative and Unknown Status Cisgender and Transgender Sexual Minority Men: Cross-sectional Study

“…Further research is needed to explore the PEP-to-PrEP pathway to biomedical HIV prevention, including reasons for uptake of, or declining, PrEP, but our findings illustrate that nearly half (3268/7108, 46%) of the past PEP users are currently taking PrEP. Moreover, our findings about lifetime PEP uptake are higher than prior reports of PEP use more broadly, where a pooled estimate of PEP use was 5.8% in high-income countries in a systematic review [ 33 ]; yet, our nationwide findings find concordance with increasing uptake over time, including similar rates of PEP use reported among young SMM (ie, 11.5% [ 34 ]) and young SMM of color (ie, 15.3% [ 35 ]) in New York City—a high-resource area for HIV prevention.…”