Methods: The serial, cross-sectional study was conducted from 2016-2018 with a total of 3,343 participants. Participants were recruited from current AFP partner organizations and their networks. Participants completed a survey that was conducted using a paper and electronic version of the instrument and disseminated via face-to-face, e-mail and social media. PrEP awareness and PrEP use were assessed using single-item, categorical questions. Chi square test of independence was used to determine differences in PrEP awareness and use over time. Then logistic regression was used to determine factors predictive of PrEP use.
Results: The Chi square results found statistically significant differences in both PrEP awareness (Χ2(2,3278) = 124.04, p< .001) and PrEP use (Χ2(4,560) = 165.29, p< .001) overall. PrEP awareness among participants grew from 27.1% in 2016 to 43.1% in 2018. Similarly, PrEP use among participants grew from 10% in 2016 to 54.8% in 2018. The logistic regression model found individuals with insurance (1.94), White individuals (1.94), individuals with high-risk (6.04), and older individuals (1.35) were more likely to report PrEP awareness. In the model predicting PrEP use, individuals with insurance (2.00), males (5.05), individuals at high-risk (5.48) and older individuals (2.01) were more likely to report current PrEP use.
Discussion:The findings suggest initiatives under AFP overall have increased the awareness and use of PrEP in Allegheny County. The dramatic increases are an important step in reducing HIV infections in the county, however uptake is still below suggested PrEP coverage in models for reducing overall HIV incidence. Furthermore, differences in use among heterosexuals, racial minorities, and younger adults, suggest the need for further interventions to increase use among high-risk groups.