Self-Perceived Risk of HIV Infection and Attitudes About Preexposure Prophylaxis Among Sexually Transmitted Disease Clinic Attendees in South Carolina

Abstract

Several domestic and international trials of the use of preexposure prophylaxis (PrEP) for HIV prevention are ongoing among groups at high risk for HIV infection. The objective of this cross-sectional study was to assess self-perceived risk of HIV infection and attitudes about PrEP among 405 sexually transmitted disease (STD) clinic attendees in South Carolina. Self-percieved risk of HIV infection and attitudes about PrEP were assessed using three questions from a self-administered survey. Ordinal logistic regression and logistic regression were used to evaluate differences in risk perception for HIV infection and attitudes about the use of PrEP among risk groups. Compared to heterosexual participants, homosexual participants were significantly more likely to have knowledge of PrEP (odds ratio [OR]=6.7, 95% confidence interval [CI]: 1.70-26.1). Compared to those participants who had 1 sexual partner in the past 3 months, individuals who had 2 to 4 sexual partners in the past 3 months were approximately 2.35 times as likely to have a lower level of agreement with the statement "I believe I am at risk of getting HIV" (p=0.0003). Compared to female participants, respondents who were male were approximately 2.8 times as likely to have a lower level of agreement with the statement "If I had to it would be very difficult for me (or my partner) to both use condoms and take daily pills to prevent HIV infection" (p<0.0001). These results suggest the need for the creation of PrEP implementation programs that are tailored to self-perceived risk perception, age, and gender.

Brief Report: The Right People, Right Places, and Right Practices: Disparities in PrEP Access Among African American Men, Women, and MSM in the Deep South

“…26, 27 However, self-perceived risk of HIV infection may be lower among some MSM populations. 28 Cultural factors for Black MSM living in the Southern U.S. are also likely unique, requiring further specialization in prevention interventions to increase awareness of PrEP and other HIV prevention services for Black MSM. Stigma associated with HIV-infection, PrEP, race or sexual practices may be exacerbated in Southern communities leading to delayed uptake of HIV prevention services.…”

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

“…In a study on attitudes about using PrEP among 405 sexually transmitted disease clinic patients, males were less likely to report both using condoms and taking a daily medication to prevent HIV infection than females (Whiteside, Harris, Scanlon, Clarkson, & Duffus, 2011). In another study with STD clinic attendees in Chicago, there was significant interest in PrEP (84% of the sample).…”

Attitudes and Program Preferences of African-American Urban Young Adults About Pre-Exposure Prophylaxis (PrEP)

“…Although PrEP trials have shown efficacy for both MSM and heterosexual women and men, eight of the ten published surveys assessing awareness and attitudes toward the use of PrEP in U.S. populations were conducted exclusively with men who have sex with men (MSM) (Barash & Golden, 2010;Golub, Kowalczyk, Weinberger, & Parsons, 2010;Koblin et al, 2008;Liu et al, 2008;Mansergh et al, 2010;Mehta et al, 2011;Mimiaga, Case, Johnson, Safren, & Mayer, 2009;Voetsch, Heffelfinger, Begley, Jafa-Bhushan, & Sullivan, 2007); one with a primarily, but not exclusively, homosexual/bisexual male population (Kellerman et al, 2006), and only one with a largely heterosexual STD clinic population (Whiteside, Harris, Scanlon, Clarkson, & Duffus, 2011). These surveys elicited responses to discrete choice questions about anticipated use of PrEP and awareness of PrEP and were all conducted while trials were underway and efficacy results were not yet known.…”