Abstract: PrEP Uptake, Adherence and Discontinuation Among YMSM in California Who Use Geosocial Networking Applications (Society for Social Work and Research 21st Annual Conference - Ensure Healthy Development for all Youth)

Schedule:

Friday, January 13, 2017: 2:45 PM

Balconies L (New Orleans Marriott)

* noted as presenting author

Ian W. Holloway, PhD, MSW, MPH, Assistant Professor, University of California, Los Angeles, Los Angeles, CA

Ryan Dougherty, BS, PhD Student, University of California, Los Angeles, Los Angeles, CA

Jennifer Gildner, MS, Statistician, University of California, Los Angeles, Los Angeles, CA

Sean Beougher, MS, Research Manager, University of California, Los Angeles, Los Angeles, CA

Craig Pulsipher, MPP, MSW, State Affairs Specialist, AIDS Project Los Angeles, Los Angeles, CA

Jorge Montoya, PhD, President and CEO, Sentient Research, West Covina, CA

Arleen Leibowitz, PhD, Professor Emeritus, University of California, Los Angeles, Los Angeles, CA

Background: Young gay, bisexual and other men who have sex with men (hereafter YMSM) who use geosocial networking applications (GSN apps) are at heightened risk for new HIV infections. While pre-exposure prophylaxis (PrEP) is a useful tool in preventing new infections among this group, little is known about PrEP uptake and adherence among YMSM who use GSN apps. The present study sought to understand current rates of PrEP uptake among YMSM who use GSN apps, correlates of PrEP uptake, adherence rates for those prescribed PrEP and reasons for discontinuation among those who stopped using PrEP.

Methods: Data were collected using a cross-sectional survey of YMSM (ages 18-24) in California using targeted advertising on popular GSN apps (n=761). Measures included current and past use of PrEP, demographic characteristics, sexual risk behaviors, and PrEP adherence. Current/past PrEP users were asked reasons for initiating PrEP. Those who discontinued PrEP were asked their reasons for stopping. Statistically significant correlates of PrEP uptake at the bivariate level were entered into multivariate logistic regression models predicting PrEP uptake. Reasons for initiation and discontinuation of PrEP use are reported descriptively.

Results: YMSM (Mean age=23; SD=3.2) were racially/ethnically diverse (white=21.7%; Black/African American=25.4%; Hispanic/Latino=31.9%; Other=21.0%) and primarily gay identified (81.9%). Less than one tenth were current or past PrEP users (9.7%). Those who made over $30,000/year (OR=4.13 ; CI : 1.87-9.12), reported unprotected condomless anal sex (OR : 3.41 ; CI : 1.71-6.78), had an HIV-positive sex partner (OR : 2.87 ; CI : 1.53-5.38), used poppers (amyl nitrate)(OR : 3.47 ; 1.96-6.13) and had a recent STI diagnosis (OR : 2.90 ; CI : 1.64-5.13) were more likely to use PrEP compared to those who did not. PrEP adherence among current users was high (92.5% reporting > 6-7 pills/week). Top reasons for discontinuation were related to fears about long-term side effects (33.3%), cost of the medication (28.6%), and cost of required medical visits (19.0%).

Conclusions and Implications: YMSM who use GSN apps are prime candidates for PrEP; however, uptake remains low. Concerns about cost may be addressed through insurance enrollment and pharmaceutical company-sponsored medication assistance programs; however, use of public funds for PrEP should be explored. GSN apps may be useful tools for information and PrEP screening. GSN app users who are also PrEP users may benefit from technology assisted adherence monitoring.