Racial disparities in HIV pre-exposure prophylaxis (PrEP) awareness and uptake among white, Black, and Indigenous men in Canada: Analysis of data from the I'm Ready national HIV self-testing study.

IF 2.9 4区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Canadian Journal of Public Health-Revue Canadienne De Sante Publique Pub Date : 2025-03-19 DOI:10.17269/s41997-025-01009-5

Wale Ajiboye, Wangari Tharao, Maureen Owino, Lena Soje, Jason M Lo Hog Tian, Amy Ly, Margaret Kisikaw Piyesis, Albert McLeod, Mathew Fleury, Kristin McBain, Notisha Massaquoi, Tegan Mosugu, Jaris Swidrovich, Darrell H S Tan, LaRon Nelson, Sean B Rourke

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引用次数: 0

Abstract

Objectives: Black and Indigenous men in Canada continue to experience significant and disproportionate burden of new HIV infection. The purpose of this study was to understand racial differences in PrEP awareness and use, and PrEP cascade among white, Black, and Indigenous men in Canada with the intention to provide evidence for immediate action in our publicly funded health care system.

Methods: We performed a secondary analysis (n = 4294) of cross-sectional data from the I'm Ready national HIV self-testing research program launched in June 2021 and running through December 2023. Binary logistic regression was used to assess racial differences in PrEP awareness and uptake. A proposed PrEP cascade was developed using the data on awareness, uptake, and retention in PrEP care.

Results: Black participants (OR = 0.34, CI 0.29, 0.39), who are gbMSM (OR = 0.27, CI 0.21, 0.35), aged 18-45 (OR = 0.35, CI 0.30, 0.40), living in urban (OR = 0.41, CI 0.33, 0.51) or rural areas (OR = 0.33, CI 0.26, 0.44), and who are PrEP-eligible (OR = 0.34, CI 0.28, 0.40), were less likely to be aware of PrEP than white participants. Indigenous participants (OR = 0.57, CI 0.44, 0.75), aged 18-45 (OR = 0.57, CI 0.43, 0.75), living in rural communities (OR = 0.15, CI 0.25, 0.57), and who are PrEP-eligible (OR = 0.62, CI 0.46, 0.83), were less likely to be aware of PrEP than white participants. For PrEP uptake, Black participants (OR = 0.61, CI 0.46, 0.82), aged 18-45 (OR = 0.59, CI 0.44, 0.80), living in rural communities (OR = 0.44, CI 0.23, 0.84), and PrEP-eligible (OR = 0.62, CI 0.46, 0.85), were less likely to be on PrEP than white participants. Also, Indigenous men living in urban areas were more likely to be on PrEP than white participants (OR = 1.65, CI 1.01, 2.69).

Conclusion: Community-based and public health interventions are immediately needed to increase PrEP awareness, access, and uptake for Black and Indigenous communities in Canada.

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来源期刊

Canadian Journal of Public Health-Revue Canadienne De Sante Publique PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

6.10

自引率

4.70%

发文量

128

期刊介绍： The Canadian Journal of Public Health is dedicated to fostering excellence in public health research, scholarship, policy and practice. The aim of the Journal is to advance public health research and practice in Canada and around the world, thus contributing to the improvement of the health of populations and the reduction of health inequalities. CJPH publishes original research and scholarly articles submitted in either English or French that are relevant to population and public health. CJPH is an independent, peer-reviewed journal owned by the Canadian Public Health Association and published by Springer. Énoncé de mission La Revue canadienne de santé publique se consacre à promouvoir l’excellence dans la recherche, les travaux d’érudition, les politiques et les pratiques de santé publique. Son but est de faire progresser la recherche et les pratiques de santé publique au Canada et dans le monde, contribuant ainsi à l’amélioration de la santé des populations et à la réduction des inégalités de santé. La RCSP publie des articles savants et des travaux inédits, soumis en anglais ou en français, qui sont d’intérêt pour la santé publique et des populations. La RCSP est une revue indépendante avec comité de lecture, propriété de l’Association canadienne de santé publique et publiée par Springer.