One-third of gay and bisexual men who take PrEP discontinue use within three years

Using data from the Generations Study, a national probability sample of LGB people in the U.S., researchers explored familiarity, attitudes, uptake, and discontinuation of PrEP among gay and bisexual men from 2016 to 2018. This is the first study to document longitudinal trends in PrEP use in a national probability sample of gay and bisexual men at risk for HIV.

Researchers found that among gay and bisexual men, attitudes toward PrEP were mostly positive, but more than a quarter (27%) of gay and bisexual men who were both eligible for and familiar with PrEP had a negative attitude towards it. While uptake of PrEP increased over the study period, overall use remained persistently low.

“Stigma around the use of PrEP, as well as concerns regarding long-term side effects and conflicting messages from AIDS service providers, may foster confusion around the benefits of taking PrEP,” said study author llan H. Meyer, Ph.D., Distinguished Senior Scholar of Public Policy at the Williams Institute. “Multi-level interventions are needed to improve education, reduce barriers to access, and promote use among gay and bisexual men.”

KEY FINDINGS

• PrEP familiarity increased considerably between 2016 and 2018 among those eligible for PrEP from 60% to 92%.
• Favorable attitudes toward PrEP increased more modestly from 68% in 2016 to 73% in 2018.
• PrEP use increased by 90% between 2016 (4%) and 2018 (8%). However, overall use among eligible men remained low.
• Among respondents who reported PrEP use, 33% subsequently discontinued PrEP.

“PrEP uptake has been slow, especially among racial/ethnic minority gay and bisexual men,” said lead author Ian W. Holloway, Associate Professor of Social Welfare at the UCLA Luskin School of Public Affairs. “We’re hopeful that new innovations in PrEP delivery, including on-demand dosing and injectable PrEP, can help expand PrEP coverage with diverse gay and bisexual men in the coming years.”

Read the report

ABOUT THE STUDY

The report, “Longitudinal trends in PrEP familiarity, attitudes, use and discontinuation among a national probability sample of gay and bisexual men, 2016–2018” appears in PLOS ONE and is co-authored by Ian W. Holloway, Ph.D., L.C.S.W, M.P.H., Evan A. Krueger, Ph.D., Ilan H. Meyer, Ph.D., Marguerita Lightfoot, Ph.D., David M. Frost, Ph.D., and Phillip L. Hammack, Ph.D.

Research reported in this report is part of the Generations study, supported by the National Institute of Child Health and Human Development (NICHD) of the National Institutes of Health, under award number R01HD078526. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Generations investigators are Ilan H. Meyer, Ph.D., (PI, UCLA); David M. Frost, Ph.D., (University College London); Phillip L. Hammack, Ph.D., (UCSC); Marguerita Lightfoot, Ph.D., (UCSF); Stephen T. Russell, Ph.D. (University of Texas, Austin) and Bianca D.M. Wilson, Ph.D., (UCLA) Co-Investigators are listed alphabetically.

The Williams Institute at UCLA School of Law, a think tank on sexual orientation and gender identity law and public policy, is dedicated to conducting rigorous, independent research with real-world relevance.