Differences Among Current Pre-exposure Prophylaxis (PrEP) Users, Former Users, and Nonusers in a Community Sample in Two Midwestern U.S. Cities: Implications for Interventions to Promote PrEP Uptake and Adherence

Disparate rates of HIV infection among Black MSM and TGW emphasize the need for interventions designed to overcome obstacles to increasing PrEP adoption within these populations. This study compared PrEP-use groups on a variety of attitudinal and behavioral factors related to PrEP adoption. Regression analysis confirmed that current and former users demonstrated greater PrEP knowledge and communicated more frequently to friends about PrEP and its benefits than nonusers. Former users exhibited more positive attitudes and perceived less stigma regarding PrEP use than other groups. Current users reported the highest prevalence of condomless anal sex and multiple partners; conversely, former users were most often in stable monogamous relationships. Our findings are consistent with the notion of prevention-effective adherence and advance our understanding of attitudinal supports for that paradigm. This research also suggests that recruitment of former PrEP users could increase the pool of effective peer behavior-change agents in future intervention efforts.