Ongoing Disparities in Prediagnosis Preexposure Prophylaxis Use Among Persons Recently Diagnosed With HIV in New York City, 2015-2017

To quantify sociodemographic disparities in prediagnosis preexposure prophylaxis (PrEP) use in persons recently diagnosed with HIV in New York City and assigned for partner services. We used partner services data from November 2015 to September 2017 from persons diagnosed with HIV in the past 12 months (n = 3739) to compare individuals with self-reported or documented pre-HIV diagnosis PrEP use ("prediagnosis PrEP users") with those having none ("never users"). We constructed a penalized likelihood regression model generating sociodemographic predictors of prediagnosis PrEP use, employing Firth's adjustment for the rare outcome. We found report of prediagnosis PrEP use in 95 persons (3%). The adjusted odds ratios (AORs) of prediagnosis PrEP use were lower among non-Hispanic Blacks (AOR = 0.18; 95% confidence interval [CI] = 0.09, 0.32) and Hispanics (AOR = 0.31; 95% CI = 0.17, 0.55) than among non-Hispanic Whites, among persons aged 30 years or older (AOR = 0.45; 95% CI = 0.28, 0.72) than those younger than 30 years, among cis-women (AOR = 0.13; 95% CI = 0.02, 0.48) than cis-men, and among residents of Queens (AOR = 0.25; 95% CI = 0.10, 0.55) than those of Manhattan. Disparities in HIV prevention based on race/ethnicity, gender, age, and local geography may manifest themselves in differential PrEP use.