Sexual violence, PrEP discussion, and PrEP use among HIV-negative men who have sex with men in 23 U.S. urban areas, National HIV Behavioral Surveillance, 2017

BackgroundMen who have sex with men (MSM) who experience sexual violence are at increased risk for HIV. Pre-exposure prophylaxis (PrEP) is effective in preventing HIV infection. Associations between sexual violence and PrEP discussion or PrEP use among MSM are not well-understood. MethodsNational HIV Behavioral Surveillance used venue-based sampling methods to recruit and interview MSM in 23 U.S. urban areas in 2017. We estimated the prevalence of sexual violence and examined associations between sexual violence and PrEP discussion with a health care provider (HCP) or PrEP use among HIV-negative MSM in the past 12 months. We reported weighted percentages and 95% confidence intervals (CI). Adjusted prevalence ratios (aPR) with 95% CIs were calculated using logistic regression with predicted margins to compare groups. ResultsAmong 7,121 HIV-negative MSM, 4.2% (95% CI: 3.6%-4.8%) experienced sexual violence in the past 12 months. Sexual violence was not independently associated with PrEP discussion with HCP (47.6% vs. 40.0%; aPR = 1.16, 95% CI: 0.98-1.37). MSM who experienced sexual violence were more likely to use PrEP than those who did not experience sexual violence, even after adjusting for demographic differences (34.9% vs. 25.7%; aPR = 1.34, 95% CI: 1.07-1.67). ConclusionsOverall PrEP discussion and PrEP use were low among HIV-negative MSM. PrEP use was higher among MSM who experienced sexual violence. Supportive patient-provider relationships that foster PrEP discussion and sexual violence screening in healthcare settings may be important to identifying HIV risk and PrEP needs while assessing MSMs safety.