Use of HIV pre-exposure prophylaxis among men who have sex with men in England: data from the AURAH2 prospective study

Prospective cohort study (1,162 men from 3 sexual health clinics) found that pre-exposure prophylaxis (PrEP) use increased from 0% in 2013 to 43% in 2018. Predictors for initiating PrEP included age 40-44 years, recent HIV test, and chemsex-related drug use.

SPS commentary:

According to a commentary, the disparities in PrEP uptake noted in this study reinforce results from other settings, e.g. research in the USA which has shown that people from ethnic minorities and marginalised groups are less likely to initiate PrEP. Maximising persistence of PrEP use among men who have sex with men (MSM) who are at high risk is crucial to reducing HIV transmission. However, disparities similar to those for PrEP uptake have been associated with decreased PrEP adherence and discontinuation of PrEP.  Although the rapid PrEP uptake among MSM most at risk of HIV in the UK and elsewhere is a good outcome, disparities in PrEP uptake and persistence are likely to lead to an uneven effect of PrEP in reducing HIV transmissions.  PrEP programme implementers and policy makers will need to understand these disparities and develop specific interventions to address them to harness the potential public health, community, and individual benefits of PrEP.


The Lancet Public Health

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