Associations of HIV pre-exposure prophylaxis (PrEP) indication, HIV risk perception and unwillingness to use PrEP among people who inject drugs in Baltimore, MD

Background: Perceived HIV risk may impact willingness to initiate PrEP among people who inject drugs (PWID). Methods: We analyzed baseline data from PrEP eligible PWID in Baltimore, MD. Risk perception was assessed by PWID relative to the average risk of their age group categorized as: higher-than,...

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Main Authors: Tarfa Verinumbe, Gregory M. Lucas, Katie Zook, Brian Weir, Miles Landry, Kathleen R. Page, Susan G. Sherman, Oluwaseun Falade-Nwulia
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Drug and Alcohol Dependence Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772724624000726
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author Tarfa Verinumbe
Gregory M. Lucas
Katie Zook
Brian Weir
Miles Landry
Kathleen R. Page
Susan G. Sherman
Oluwaseun Falade-Nwulia
author_facet Tarfa Verinumbe
Gregory M. Lucas
Katie Zook
Brian Weir
Miles Landry
Kathleen R. Page
Susan G. Sherman
Oluwaseun Falade-Nwulia
author_sort Tarfa Verinumbe
collection DOAJ
description Background: Perceived HIV risk may impact willingness to initiate PrEP among people who inject drugs (PWID). Methods: We analyzed baseline data from PrEP eligible PWID in Baltimore, MD. Risk perception was assessed by PWID relative to the average risk of their age group categorized as: higher-than, lower-than, or about average. Participants were informed of PrEP for HIV prevention and asked about their willingness to use daily PrEP. Associations of PrEP indication (categorized as injection risk only vs any sexual risk), perceived HIV risk and non-willingness to use PrEP was assessed using generalized linear models. Results: Among 489 participants, 61 % were male, 66 % were Black and mean age was 46 years. One-third (35 %) of the participants were aware of PrEP and <1 % had used PrEP in the prior 30 days. Overall, 30 % of PWID reported lower-than-average perceived HIV risk and 18 % reported non-willingness to use PrEP. Participants with injection risk only were more likely (aOR: 2.75; 95 %CI: 1.60 – 4.73) to report having lower-than-average perceived HIV risk compared to those with any sexual risk. Participants with lower-than-average perceived risk were more likely to report non-willingness to use PrEP compared to those with higher perceived risk (adjusted PR: 1.91; 95 %CI: 1.18 – 3.10). Conclusion: A considerable proportion of PWID eligible for PrEP reported having low risk of HIV acquisition despite being eligible for PrEP. Consistent and tailored PrEP messaging that addresses drug use HIV risk perception may be critical to increasing PrEP uptake among PWID.
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spelling doaj-art-b91e6a1c76ec43f8abac384b85b204d02024-12-12T05:24:27ZengElsevierDrug and Alcohol Dependence Reports2772-72462024-12-0113100288Associations of HIV pre-exposure prophylaxis (PrEP) indication, HIV risk perception and unwillingness to use PrEP among people who inject drugs in Baltimore, MDTarfa Verinumbe0Gregory M. Lucas1Katie Zook2Brian Weir3Miles Landry4Kathleen R. Page5Susan G. Sherman6Oluwaseun Falade-Nwulia7Johns Hopkins University School of Medicine, Division of Infectious Diseases, Baltimore, MD 21205, USA; Correspondence to: Johns Hopkins University School of Medicine, Division of Infectious Diseases, 5200 Eastern Ave, Baltimore, MD 21205, USA.Johns Hopkins University School of Medicine, Division of Infectious Diseases, Baltimore, MD 21205, USAJohns Hopkins University School of Medicine, Division of Infectious Diseases, Baltimore, MD 21205, USAJohns Hopkins University Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore, MD 21205, USAJohns Hopkins University School of Medicine, Division of Infectious Diseases, Baltimore, MD 21205, USAJohns Hopkins University School of Medicine, Division of Infectious Diseases, Baltimore, MD 21205, USAJohns Hopkins University Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore, MD 21205, USAJohns Hopkins University School of Medicine, Division of Infectious Diseases, Baltimore, MD 21205, USABackground: Perceived HIV risk may impact willingness to initiate PrEP among people who inject drugs (PWID). Methods: We analyzed baseline data from PrEP eligible PWID in Baltimore, MD. Risk perception was assessed by PWID relative to the average risk of their age group categorized as: higher-than, lower-than, or about average. Participants were informed of PrEP for HIV prevention and asked about their willingness to use daily PrEP. Associations of PrEP indication (categorized as injection risk only vs any sexual risk), perceived HIV risk and non-willingness to use PrEP was assessed using generalized linear models. Results: Among 489 participants, 61 % were male, 66 % were Black and mean age was 46 years. One-third (35 %) of the participants were aware of PrEP and <1 % had used PrEP in the prior 30 days. Overall, 30 % of PWID reported lower-than-average perceived HIV risk and 18 % reported non-willingness to use PrEP. Participants with injection risk only were more likely (aOR: 2.75; 95 %CI: 1.60 – 4.73) to report having lower-than-average perceived HIV risk compared to those with any sexual risk. Participants with lower-than-average perceived risk were more likely to report non-willingness to use PrEP compared to those with higher perceived risk (adjusted PR: 1.91; 95 %CI: 1.18 – 3.10). Conclusion: A considerable proportion of PWID eligible for PrEP reported having low risk of HIV acquisition despite being eligible for PrEP. Consistent and tailored PrEP messaging that addresses drug use HIV risk perception may be critical to increasing PrEP uptake among PWID.http://www.sciencedirect.com/science/article/pii/S2772724624000726Pre-exposure prophylaxisPeople who inject drugsHIVRisk perceptionUnited States
spellingShingle Tarfa Verinumbe
Gregory M. Lucas
Katie Zook
Brian Weir
Miles Landry
Kathleen R. Page
Susan G. Sherman
Oluwaseun Falade-Nwulia
Associations of HIV pre-exposure prophylaxis (PrEP) indication, HIV risk perception and unwillingness to use PrEP among people who inject drugs in Baltimore, MD
Drug and Alcohol Dependence Reports
Pre-exposure prophylaxis
People who inject drugs
HIV
Risk perception
United States
title Associations of HIV pre-exposure prophylaxis (PrEP) indication, HIV risk perception and unwillingness to use PrEP among people who inject drugs in Baltimore, MD
title_full Associations of HIV pre-exposure prophylaxis (PrEP) indication, HIV risk perception and unwillingness to use PrEP among people who inject drugs in Baltimore, MD
title_fullStr Associations of HIV pre-exposure prophylaxis (PrEP) indication, HIV risk perception and unwillingness to use PrEP among people who inject drugs in Baltimore, MD
title_full_unstemmed Associations of HIV pre-exposure prophylaxis (PrEP) indication, HIV risk perception and unwillingness to use PrEP among people who inject drugs in Baltimore, MD
title_short Associations of HIV pre-exposure prophylaxis (PrEP) indication, HIV risk perception and unwillingness to use PrEP among people who inject drugs in Baltimore, MD
title_sort associations of hiv pre exposure prophylaxis prep indication hiv risk perception and unwillingness to use prep among people who inject drugs in baltimore md
topic Pre-exposure prophylaxis
People who inject drugs
HIV
Risk perception
United States
url http://www.sciencedirect.com/science/article/pii/S2772724624000726
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