Urban, formerly incarcerated, black, heterosexual men with substance use disorders: eligible for pre-exposure prophylaxis (PrEP) but unaware of their vulnerability to HIV acquisition.

Abstract

Research on incarcerated men indicates low PrEP access even though HIV disproportionately affects them. Intersecting attributes - urban, incarcerated, Black, heterosexual men with substance use diagnoses (SUDs) - improves the odds of HIV transmission/acquisition. It is crucial to determine, among "key populations," who might be eligible to take PrEP. PrEP eligibility criteria have been used inconsistently in research. This exploratory, quantitative, study uses criteria from the United States Centers for Disease Control and Prevention to determine eligibility: HIV-negative test and sexually active plus a sexual partner living with HIV and/or diagnosed with an STI and/or inconsistent or no condom use for intercourse. We found a considerable percentage (n = 61; 32.8%) of PrEP-eligible individuals (n = 186) in a sample of urban, formerly incarcerated, Black, heterosexual men with SUDs. Most PrEP-eligible participants (78.7%) did not receive PrEP information from health service providers. Most participants (85.2%) reported they were "not likely" to contract HIV. This study demonstrates the accurate determination of PrEP eligibility and the need to assess individuals' awareness of their vulnerabilities to HIV acquisition - the first step needed before accessing PrEP. Interventions to improve PrEP access must focus on the accurate determination of PrEP eligibility, individuals' awareness of their vulnerability to HIV acquisition and how/when they receive information about PrEP.