Ongoing Disparities in Prediagnosis Preexposure Prophylaxis Use Among Persons Recently Diagnosed With HIV in New York City, 2015-2017.

Abstract

<i>Objectives.</i> To quantify sociodemographic disparities in prediagnosis preexposure prophylaxis (PrEP) use in persons recently diagnosed with HIV in New York City and assigned for partner services.<i>Methods.</i> We used partner services data from November 2015 to September 2017 from persons diagnosed with HIV in the past 12 months (n = 3739) to compare individuals with self-reported or documented pre-HIV diagnosis PrEP use ("prediagnosis PrEP users") with those having none ("never users"). We constructed a penalized likelihood regression model generating sociodemographic predictors of prediagnosis PrEP use, employing Firth's adjustment for the rare outcome.<i>Results.</i> We found report of prediagnosis PrEP use in 95 persons (3%). The adjusted odds ratios (AORs) of prediagnosis PrEP use were lower among non-Hispanic Blacks (AOR = 0.18; 95% confidence interval [CI] = 0.09, 0.32) and Hispanics (AOR = 0.31; 95% CI = 0.17, 0.55) than among non-Hispanic Whites, among persons aged 30 years or older (AOR = 0.45; 95% CI = 0.28, 0.72) than those younger than 30 years, among cis-women (AOR = 0.13; 95% CI = 0.02, 0.48) than cis-men, and among residents of Queens (AOR = 0.25; 95% CI = 0.10, 0.55) than those of Manhattan.<i>Conclusions.</i> Disparities in HIV prevention based on race/ethnicity, gender, age, and local geography may manifest themselves in differential PrEP use.