Awareness of Pre-exposure Prophylaxis (PrEP) Among Women Who Inject Drugs in NYC: the Importance of Networks and Syringe Exchange Programs for HIV Prevention

Overview

Journal Harm Reduct J

Publisher Biomed Central

Specialties Pharmacology
Psychiatry

Date 2017 Jul 1

PMID 28662716

Citations 75

Authors

Suzan M Walters

Kathleen H Reilly

Alan Neaigus

Sarah Braunstein

Affiliations

Soon will be listed here.

Abstract

Background: Women who inject drugs (WWID) are at heightened risk for HIV due to biological, behavioral, and structural factors. Pre-exposure prophylaxis (PrEP) could aid in HIV prevention for WWID. However, little is known about WWID awareness of PrEP, which is a necessary step that must occur before PrEP uptake. We report factors associated with greater awareness among WWID to identify efficient means of awareness dissemination.

Methods: Data from the 2015 National HIV Behavioral Surveillance (NHBS) system cycle on injection drug use collected in New York City (NYC) were used. Bivariable analyses, using chi-squared statistics, were conducted to examine correlates of awareness of PrEP with socio-demographic, behavioral, and health care variables. Multivariable logistic regression was used to estimate adjusted associations and determine differences in awareness of PrEP.

Results: The analysis consisted of 118 WWID. Awareness of PrEP was relatively low (31%), and risk factors were high. In the last 12 months, almost two thirds (65%) reported condomless sex, approximately one third (31%) reported transactional sex, and one third (32%) reported sharing injection equipment. In multivariable logistic regression, increased PrEP awareness was associated with reported transactional sex (AOR 3.32, 95% CI 1.22-9.00) and having a conversation about HIV prevention at a syringe exchange program (SEP) (AOR 7.61, 95% CI 2.65-21.84). We did not find race, education, household income, age, binge drinking, or sexual identity to be significantly associated with PrEP awareness.

Conclusions: Large proportions of WWID were unaware of PrEP. These findings suggest that social networks (specifically sex work and SEP networks) are an efficient means for disseminating messaging about prevention materials such as PrEP. We recommend that SEP access increase, SEP processes be adopted in other health care settings, and WWID networks be utilized to increase PrEP awareness.

Citing Articles

Assessing awareness and utilisation of pre-exposure prophylaxis for HIV prevention among women who inject drugs in Lagos, Nigeria: a cross-sectional study.

Onigbogi O, Eghaghe O, Onigbogi M, Ojo O, Babalola O BMJ Public Health. 2025; 2(1):e000293.

PMID: 40018130 PMC: 11812754. DOI: 10.1136/bmjph-2023-000293.

Centering autonomy and choice to support oral PrEP utilization among people who inject drugs: qualitative lessons from HPTN 094 INTEGRA.

Perez-Brumer A, Schmidt R, Kennedy R, Lake J, Villarreal Y, Bornstein S Addict Sci Clin Pract. 2024; 19(1):92.

PMID: 39696609 PMC: 11653907. DOI: 10.1186/s13722-024-00520-3.

Protocol: the American Women: Assessing Risk Epidemiologically (AWARE) cohort study.

Schnall R, Kempf M, Phillips 2nd G, Dionne J, Wingood G, Long D BMC Public Health. 2024; 24(1):3422.

PMID: 39695485 PMC: 11653693. DOI: 10.1186/s12889-024-20810-4.

Supporting Pre-Exposure Prophylaxis Uptake: Exploring Social Network Characteristics among Black Women and Acceptability of Social Network Strategies.

Johnson A, Devlin S, Hill M, Ott E, Friedman E, Haider S Healthcare (Basel). 2024; 12(17).

PMID: 39273793 PMC: 11395160. DOI: 10.3390/healthcare12171769.

HIV and sexual risk behaviours by 18-25-year-old youth at Nyandeni Municipality in the Eastern Cape.

Mntonintshi-Mketo L, Netangaheni R, Lefoka M Health SA. 2024; 29:2541.

PMID: 39229314 PMC: 11369564. DOI: 10.4102/hsag.v29i0.2541.

References

Liu A, Kittredge P, Vittinghoff E, Raymond H, Ahrens K, Matheson T . Limited knowledge and use of HIV post- and pre-exposure prophylaxis among gay and bisexual men. J Acquir Immune Defic Syndr. 2008; 47(2):241-7. View

Magura S, Nwakeze P, ROSENBLUM A, Joseph H . Substance misuse and related infectious diseases in a soup kitchen population. Subst Use Misuse. 2000; 35(4):551-83. DOI: 10.3109/10826080009147472. View

Neaigus A, Reilly K, Jenness S, Hagan H, Wendel T, Gelpi-Acosta C . Dual HIV risk: receptive syringe sharing and unprotected sex among HIV-negative injection drug users in New York City. AIDS Behav. 2013; 17(7):2501-9. DOI: 10.1007/s10461-013-0496-y. View

Salganik M . Variance estimation, design effects, and sample size calculations for respondent-driven sampling. J Urban Health. 2006; 83(6 Suppl):i98-112. PMC: 1705515. DOI: 10.1007/s11524-006-9106-x. View

Baeten J, Donnell D, Ndase P, Mugo N, Campbell J, Wangisi J . Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012; 367(5):399-410. PMC: 3770474. DOI: 10.1056/NEJMoa1108524. View

Inciardi J, Surratt H, Kurtz S . HIV, HBV, and HCV infections among drug-involved, inner-city, street sex workers in Miami, Florida. AIDS Behav. 2005; 10(2):139-47. DOI: 10.1007/s10461-005-9049-3. View

Adimora A, Schoenbach V, Bonas D, Martinson F, Donaldson K, Stancil T . Concurrent sexual partnerships among women in the United States. Epidemiology. 2002; 13(3):320-7. DOI: 10.1097/00001648-200205000-00013. View

Galea S, Vlahov D . Social determinants and the health of drug users: socioeconomic status, homelessness, and incarceration. Public Health Rep. 2002; 117 Suppl 1:S135-45. PMC: 1913691. View

Thigpen M, Kebaabetswe P, Paxton L, Smith D, Rose C, Segolodi T . Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana. N Engl J Med. 2012; 367(5):423-34. DOI: 10.1056/NEJMoa1110711. View

10.

Lansky A, Finlayson T, Johnson C, Holtzman D, Wejnert C, Mitsch A . Estimating the number of persons who inject drugs in the united states by meta-analysis to calculate national rates of HIV and hepatitis C virus infections. PLoS One. 2014; 9(5):e97596. PMC: 4026524. DOI: 10.1371/journal.pone.0097596. View

11.

. Update to Interim Guidance for Preexposure Prophylaxis (PrEP) for the Prevention of HIV Infection: PrEP for injecting drug users. MMWR Morb Mortal Wkly Rep. 2013; 62(23):463-5. PMC: 4604844. View

12.

Aspinall E, Nambiar D, Goldberg D, Hickman M, Weir A, Van Velzen E . Are needle and syringe programmes associated with a reduction in HIV transmission among people who inject drugs: a systematic review and meta-analysis. Int J Epidemiol. 2013; 43(1):235-48. DOI: 10.1093/ije/dyt243. View

13.

Smith D, Van Handel M, Wolitski R, Stryker J, Hall H, Prejean J . Vital Signs: Estimated Percentages and Numbers of Adults with Indications for Preexposure Prophylaxis to Prevent HIV Acquisition--United States, 2015. MMWR Morb Mortal Wkly Rep. 2015; 64(46):1291-5. DOI: 10.15585/mmwr.mm6446a4. View

14.

Schechter M, Strathdee S, Cornelisse P, Currie S, Patrick D, Rekart M . Do needle exchange programmes increase the spread of HIV among injection drug users?: an investigation of the Vancouver outbreak. AIDS. 1999; 13(6):F45-51. DOI: 10.1097/00002030-199904160-00002. View

15.

Rhodes T, Singer M, Bourgois P, Friedman S, Strathdee S . The social structural production of HIV risk among injecting drug users. Soc Sci Med. 2005; 61(5):1026-44. DOI: 10.1016/j.socscimed.2004.12.024. View

16.

McCreesh N, Frost S, Seeley J, Katongole J, Tarsh M, Ndunguse R . Evaluation of respondent-driven sampling. Epidemiology. 2011; 23(1):138-47. PMC: 3277908. DOI: 10.1097/EDE.0b013e31823ac17c. View

17.

Escudero D, Lurie M, Kerr T, Howe C, Marshall B . HIV pre-exposure prophylaxis for people who inject drugs: a review of current results and an agenda for future research. J Int AIDS Soc. 2014; 17:18899. PMC: 3969508. DOI: 10.7448/IAS.17.1.18899. View

18.

Song J, Safaeian M, Strathdee S, Vlahov D, Celentano D . The prevalence of homelessness among injection drug users with and without HIV infection. J Urban Health. 2001; 77(4):678-87. PMC: 3456762. DOI: 10.1007/BF02344031. View

19.

Grant R, Lama J, Anderson P, McMahan V, Liu A, Vargas L . Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010; 363(27):2587-99. PMC: 3079639. DOI: 10.1056/NEJMoa1011205. View

20.

Rich J, Adashi E . Ideological Anachronism Involving Needle and Syringe Exchange Programs: Lessons From the Indiana HIV Outbreak. JAMA. 2015; 314(1):23-4. PMC: 4496270. DOI: 10.1001/jama.2015.6303. View