HIV / STI
Pre-exposure prophylaxis (PrEP) indicators by race/ethnicity among persons who inject drugs (PWID) receiving CDC-funded HIV testing Deesha Patel* Deesha Patel Weston O. Williams Carolyn Wright
Pre-exposure prophylaxis (PrEP) program performance reduces risk of HIV acquisition. However, use among persons who inject drugs (PWID) remains low, especially for PWID of non-White race/ethnicity. We examined program performance indicators for PrEP use and PrEP-related services by race/ethnicity among PWID testing negative for HIV infection via CDC-funded HIV testing.
Using 2019-2021 HIV testing data submitted by CDC-funded health departments and community-based organizations to the National HIV Prevention Program Monitoring & Evaluation system, we analyzed the following program performance indicators for HIV-negative PWID: current PrEP use, eligibility for PrEP referral among those not currently using PrEP, referral to a PrEP provider among those eligible, and assistance with linkage to a PrEP provider among those referred. To compare by race/ethnicity, we calculated aPRs with 95% CIs and p-values in robust Poisson models, adjusting for age, gender, U.S. Census region, and year.
The prevalence of current PrEP use ranged from 0.4% to 4.0%; in adjusted models, current use was higher for Asian (4.0%; aPR=3.89), multiracial (2.2%; aPR=2.48), Black (1.8%; aPR=2.05), and Hispanic/Latino (1.5%; aPR=1.84) PWID versus White PWID (0.9%; all p<0.05). Eligibility was higher for Black (60.6%; aPR=1.06) and multiracial (60.3%; aPR=1.06) PWID versus White PWID (59.3%; all p<0.05). Referral was higher for Native Hawaiian/Pacific Islander (50.4%; aPR=1.20) and Black (50.4%; aPR=1.18) PWID, but lower for Hispanic/Latino PWID (36.2%; aPR=0.93), versus White PWID (45.4%; all p<0.05). Assistance with linkage was higher for Native Hawaiian/Pacific Islander (81.0%; aPR=1.33), Black (78.8%; aPR=1.18), and multiracial (67.5%; aPR=1.09) PWID versus White PWID (63.8%; all p<0.05).
PrEP use was low among all PWID testing negative for HIV infection. PrEP-related services generally reached a greater proportion of Black PWID; however, PrEP-related services need to reach all racial/ethnic groups to increase PrEP use and reduce HIV acquisition among PWID.
