Pre-exposure Prophylaxis Knowledge Among Human Immunodeficiency Virus (HIV)-Positive Patients Engaged in Medical Care

Abstract

Background. Pre-exposure prophylaxis (PrEP) is a proven strategy for HIV prevention, but knowledge and uptake of PrEP in Miami remain suboptimal. People living with HIV/AIDS (PLWHA) may have HIV uninfected sexual partners who could benefit from PrEP. Few studies have addressed knowledge, attitudes, and beliefs regarding PrEP among PLWHA. Methods. We conducted a survey of PLWHA attending the perinatal or general adult clinics at a large teaching hospital in Miami. Survey items assessed demographics, relationship status and sexual practices, and prior knowledge of PrEP. Following completion of the survey, all participants were offered PrEP information and local resources for obtaining PrEP. Chi-square and Student t-tests were conducted to determine differences between subgroups. Results. The survey was completed by 73 participants. Respondents were 54.9% female, 80.3% African American, 22.5% Hispanic, and had a mean age of 44.4 years. Respondents were 83.1% heterosexual. By self-report, 29.6% had a detectable or unknown HIV viral load. Sexual activity with an HIV negative partner within the last year was reported by 31.5% of participants. A primary partner was reported by 59.2% of respondents; of those with a primary partner, 59.5% were reported to be HIV negative. Intent or desire for conception was reported by 10.9%. Of survey respondents, 31% had previously heard of PrEP, with those reporting undetectable HIV viral load more likely to be aware of PrEP compared with those with detectable or unknown viral load (p = 0.012 for difference). The most common PrEP information sources reported by those with prior PrEP awareness were media (40.9%) or a medical provider (27.3%). The majority of respondents (71.8%) accepted information about PrEP after completing the survey and 80.3% expressed that they would encourage their HIV negative partners to use PrEP in the future. Conclusion. In our diverse sample of PLWHA engaged in medical care in Miami, HIV negative sexual partners were common and few respondents had prior awareness of PrEP. Of concern, those with detectable or unknown viral load were less likely to be aware of PrEP, indicating the need for additional efforts to educate PLWHA about PrEP for their partners as part of routine HIV medical care.