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Pre-Exposure Prophylaxis (PrEP) for HIV Prevention

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Infectious Disease Epidemiology".

Deadline for manuscript submissions: closed (31 July 2023) | Viewed by 6814

Special Issue Editor


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Guest Editor
Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD 20742, USA
Interests: HIV/STI prevention; substance use; stigma; mental health; racism; homophobia

Special Issue Information

Dear Colleagues,

Pre-exposure prophylaxis (PrEP) is one of the most effective means of HIV prevention, with a reduction of approximately 99% in the sexual acquisition of HIV when taken as prescribed. PrEP has also shown significant promise in reducing HIV acquisition due to intravenous drug use. For these reasons, it has become a cornerstone of HIV prevention efforts in recent years. However, challenges persist in access, utilization, and adherence to PrEP. This is especially true for marginalized populations, who face many barriers to accessing and utilizing PrEP yet are also disproportionately affected by HIV. Comprehensive strategies to both provide PrEP access and promote uptake and adherence are critically important in not only reducing HIV disparities but addressing the HIV epidemic. Papers exploring PrEP use, adherence, and services are invited for this Special Issue. While all papers related to PrEP are welcome, we particularly encourage papers exploring PrEP use in understudied populations, injectable PrEP, methodological studies, community-based approaches to PrEP delivery and promotion, PrEP communications, and studies examining PrEP-related social and structural factors.

Dr. Rodman E. Turpin
Guest Editor

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Keywords

  • HIV
  • PrEP
  • healthcare
  • services
  • prevention

Published Papers (4 papers)

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Research

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11 pages, 305 KiB  
Article
Monkeypox-Related Stigma and Vaccine Challenges as a Barrier to HIV Pre-Exposure Prophylaxis among Black Sexual Minority Men
by Rodman E. Turpin, CJ Mandell, Aaron D. Camp, Rochelle R. Davidson Mhonde, Typhanye V. Dyer, Kenneth H. Mayer, Hongjie Liu, Thomas Coates and Bradley O. Boekeloo
Int. J. Environ. Res. Public Health 2023, 20(14), 6324; https://doi.org/10.3390/ijerph20146324 - 08 Jul 2023
Cited by 2 | Viewed by 1394
Abstract
Background: The U.S. monkeypox (mpox) outbreak of 2022 was a unique emergent public health crisis disproportionately affecting Black sexual minority men (BSMM). Similar to other stigmas, mpox-related stigma may have adverse effects on BSMM, including deterring HIV prevention such as PrEP. Methods: Our [...] Read more.
Background: The U.S. monkeypox (mpox) outbreak of 2022 was a unique emergent public health crisis disproportionately affecting Black sexual minority men (BSMM). Similar to other stigmas, mpox-related stigma may have adverse effects on BSMM, including deterring HIV prevention such as PrEP. Methods: Our study investigated the experiences and perceptions of BSMM related to mpox, including mpox-associated stigma, and PrEP engagement among BSMM. We conducted qualitative interviews of 24 BSMM attending HIV prevention-related events in the greater D.C. Metropolitan area. In-depth interviews were conducted via phone, and responses to questions specific to the mpox outbreak were analyzed using thematic analysis. Results: We identified three key themes from the analysis: Mpox-related stigma, Mpox vaccine availability concerns, and Mpox vaccine hesitancy. Participants also described relationships between each of these three themes and PrEP use. Mpox stigma was particularly relevant as it is related to sexual stigma and is a deterrent to PrEP use. A sense of health system neglect of BSMM, especially related to low mpox vaccine availability, was also described. Conclusions: We identified mpox stigma and challenges related to mpox vaccination as key themes among BSMM, with implications for PrEP use. Future research exploring medical mistrust among BSMM, particularly related to HIV prevention, is recommended. Full article
(This article belongs to the Special Issue Pre-Exposure Prophylaxis (PrEP) for HIV Prevention)
16 pages, 380 KiB  
Article
A Principal Investigator as a PrEP-Using Peer Change Agent for HIV Prevention among Black Gay and Bisexual Men: An Autoethnography
by Derek T. Dangerfield II
Int. J. Environ. Res. Public Health 2023, 20(7), 5309; https://doi.org/10.3390/ijerph20075309 - 29 Mar 2023
Cited by 2 | Viewed by 1807
Abstract
HIV pre-exposure prophylaxis (PrEP) use remains suboptimal among Black gay and bisexual men (GBM). Multilevel factors such as medication costs, intersectional stigma, patient-clinician communication, medical mistrust, side effect concerns, and low perceived HIV risk (PHR) are well-established PrEP initiation barriers for this group. [...] Read more.
HIV pre-exposure prophylaxis (PrEP) use remains suboptimal among Black gay and bisexual men (GBM). Multilevel factors such as medication costs, intersectional stigma, patient-clinician communication, medical mistrust, side effect concerns, and low perceived HIV risk (PHR) are well-established PrEP initiation barriers for this group. Peer change agents (PCAs) are culturally congruent interventionists who can circumvent multilevel PrEP barriers among Black GBM. I led an intervention as a PrEP-using PCA to improve PHR and PrEP willingness among 69 Black GBM from 2019–2022 and conducted an autoethnography to better understand multilevel barriers and identify the personal/professional challenges of being an in-group HIV interventionist serving Black SMM. Findings provide novel perspectives regarding PrEP barriers, the role of cultural homophily in behavior change interventions, and how interpersonal dynamics can impact staff fatigue, protocol fidelity, and research participation. Recommendations to prepare and support culturally congruent research staff are also provided. Full article
(This article belongs to the Special Issue Pre-Exposure Prophylaxis (PrEP) for HIV Prevention)
9 pages, 352 KiB  
Article
Is HIV Pre-Exposure Prophylaxis among Men Who Have Sex with Men Effective in a Real-World Setting? Experience with One-On-One Counseling and Support in a Sexual Health Center in Paris, 2018–2020
by Bérenger Thomas, Prescillia Piron, Elise de La Rochebrochard, Christophe Segouin and Pénélope Troude
Int. J. Environ. Res. Public Health 2022, 19(21), 14295; https://doi.org/10.3390/ijerph192114295 - 01 Nov 2022
Cited by 1 | Viewed by 1159
Abstract
HIV pre-exposure prophylaxis (PrEP) is highly effective but depends on patients’ care engagement, which is often mediocre and poorly measured in real-world settings. This study aimed to assess the effectiveness of a PrEP program in a sexual health center that included accompanying measures [...] Read more.
HIV pre-exposure prophylaxis (PrEP) is highly effective but depends on patients’ care engagement, which is often mediocre and poorly measured in real-world settings. This study aimed to assess the effectiveness of a PrEP program in a sexual health center that included accompanying measures to improve engagement. A retrospective observational study was conducted. All men who have sex with men (MSM) who initiated PrEP for the first time between 1 August 2018 and 30 June 2019 in the Fernand-Widal sexual health center, Paris, France, were included. Among the 125 MSM who initiated PrEP, the median age was 33 and most had only male partners. At initiation, 58% were considered at very high risk of HIV infection, mainly due to a history of post-exposure prophylaxis. During the first year, patients attended a median of three visits (Q1–Q3, 2–4). At 12 months, 96% (95% CI, 92.6 to 99.4) had a successful PrEP course, assessed by a novel metric. These results highlight the possibility of achieving a high PrEP success ratio among MSM in a real-world setting. The accompanying measures and one-on-one counseling by a trained counselor could explain the effectiveness of this PrEP program. Full article
(This article belongs to the Special Issue Pre-Exposure Prophylaxis (PrEP) for HIV Prevention)

Review

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11 pages, 612 KiB  
Review
Current Perspectives on the Determinants of Acceptability of Pre-Exposure Prophylaxis and Nonoccupational Post-Exposure Prophylaxis among People at Risk for HIV: A Scoping Review
by Lingmi Zhou and Sawitri Assanangkornchai
Int. J. Environ. Res. Public Health 2022, 19(19), 12605; https://doi.org/10.3390/ijerph191912605 - 02 Oct 2022
Viewed by 1733
Abstract
Pre-exposure prophylaxis (PrEP) and nonoccupational post-exposure prophylaxis (nPEP) were found to be effective HIV biomedical interventions. However, several barriers to acceptance of these interventions were discovered among populations at risk for HIV, and the Coronavirus Disease 2019 (COVID-19) pandemic may also exacerbate these. [...] Read more.
Pre-exposure prophylaxis (PrEP) and nonoccupational post-exposure prophylaxis (nPEP) were found to be effective HIV biomedical interventions. However, several barriers to acceptance of these interventions were discovered among populations at risk for HIV, and the Coronavirus Disease 2019 (COVID-19) pandemic may also exacerbate these. The current scoping review aims to update information in regards to facilitators and barriers for PrEP and nPEP acceptability among key populations collected in the past two years and to identify any existing knowledge gaps during the time of the COVID-19 pandemic. Of 1453 studies retrieved, 16 met the final inclusion criteria. The review synthesized a range of individual, PrEP-specific, psychosocial, and health system factors that may affect the acceptability of PrEP or nPEP. The conclusion from this scoping review is that more research is needed to enable a comprehensive understanding of the determinants of acceptability of PrEP and nPEP in the context of COVID-19, particularly among PWID and FSWs. Full article
(This article belongs to the Special Issue Pre-Exposure Prophylaxis (PrEP) for HIV Prevention)
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