Awareness of Post-Exposure HIV Prophylaxis in High-Risk Men Who Have Sex With Men in New York City

The team designed the current study to assess factors associated with knowledge of non-occupational post-exposure prophylaxis (nPEP) and pre-exposure prophylaxis (PrEP) for HIV. The study's subjects were 554 MSM clients of two New York City (NYC) bathhouses; the men were given a standardized survey on nPEP and PrEP at the time of HIV testing.

Sixty-three percent of the men reported unprotected sex with a male partner in the preceding 90 days, while 7 percent reported any sex with a known HIV-positive male partner. Fewer than half the men reported having a primary care provider who was aware of their MSM behavior. Awareness of nPEP or PrEP was reported by 201 men (36 percent).

In univariate analyses, the following factors were each significantly associated with being aware of nPEP or PrEP: race/ethnicity; previous HIV testing; self-identifying as gay; higher education level; having a primary care provider who was aware of their MSM behavior; reported interaction with the health care system; use of the Internet for meeting sex partners; reporting unprotected sex in the previous 90 days; reporting any sex with an HIV-positive male partner in the previous 90 days; and having a higher number of sex partners.

Multivariate analyses found that having a higher number of sex partners was significantly associated (odds ratio 5.10, p=0.02) with post-exposure prophylaxis/PrEP knowledge. Disclosure to a primary care provider also was associated, though less robustly (OR 2.10, p=0.06).

"Knowledge of nPEP or PrEP among sexually active MSM in NYC is low and is associated with having a primary provider aware of their patient's same-sex behaviors," the authors concluded. "These findings show the need for improving education about nPEP among high-risk MSM in NYC and the role of providers in these efforts."