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Differences in Attitudes About HIV Pre-Exposure Prophylaxis Use Among Stimulant Versus Alcohol Using Men Who Have Sex with Men

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Abstract

Alcohol and stimulant use are independently associated with increased HIV acquisition among men who have sex with men (MSM). We assessed differences in acceptability and perceived barriers to uptake of pre-exposure prophylaxis (PrEP) among stimulant and alcohol-using MSM in Boston. From September 2012–2013, a quantitative assessment was conducted with 254 MSM respondents who reported recent condomless sex in the context of concurrent stimulant (crack/cocaine and crystal methamphetamine; n = 132) or alcohol use (n = 122). Thirteen (5.1  %) reported previous PrEP use. In multivariable models, stimulant users were more likely to be concerned that substance use would affect PrEP adherence (aRR = 2.79, 95  % CI 1.63–4.77), and were less concerned about HIV stigma as a barrier to PrEP uptake (aRR = 0.52, 95  % CI 0.30–0.90) compared to alcohol users. Barriers to PrEP uptake and adherence differ by type of substance used. Different strategies may be required for PrEP implementation among MSM who use stimulants and alcohol.

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Acknowledgments

The project described was supported by Grant Number R21MH095535 (PIs: Mimiaga and Mitty) from the National Institute Of Mental Health. CEO was supported by Grant Number T32DA013911 (PI: Flanigan) from the National Institute on Drug Abuse and R25MH083620 (PI: Nunn) from the National Institute of Mental Health. SAS was supported by grant K24 MH094214-01 from the National Institute of Mental Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health, the National Institute on Drug Abuse, or the National Institutes of Health.

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Authors and Affiliations

  1. The Fenway Institute, Fenway Community Health, Boston, MA, USA

    Catherine E. Oldenburg, Jennifer A. Mitty, Katie B. Biello, Elizabeth F. Closson, Kenneth H. Mayer & Matthew J. Mimiaga

  2. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    Catherine E. Oldenburg & Matthew J. Mimiaga

  3. Departments of Behavioral and Social Sciences and Epidemiology, and the Institute for Community Health Promotion, Brown University School of Public Health, 121 South Main St, Providence, RI, 02903, USA

    Katie B. Biello & Matthew J. Mimiaga

  4. Department of Psychology, University of Miami, Miami, FL, USA

    Steven A. Safren

  5. Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Jennifer A. Mitty & Kenneth H. Mayer

  6. Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA

    Kenneth H. Mayer

Authors
  1. Catherine E. Oldenburg
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  2. Jennifer A. Mitty
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  3. Katie B. Biello
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  4. Elizabeth F. Closson
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  5. Steven A. Safren
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  6. Kenneth H. Mayer
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  7. Matthew J. Mimiaga
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Correspondence to Matthew J. Mimiaga.

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Oldenburg, C.E., Mitty, J.A., Biello, K.B. et al. Differences in Attitudes About HIV Pre-Exposure Prophylaxis Use Among Stimulant Versus Alcohol Using Men Who Have Sex with Men. AIDS Behav 20, 1451–1460 (2016). https://doi.org/10.1007/s10461-015-1226-4

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  • DOI: https://doi.org/10.1007/s10461-015-1226-4

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