Development of a targeted educational intervention to increase pre-exposure prophylaxis uptake among cisgender men and transgender individuals who have sex with men and use methamphetamine in Seattle (WA, USA)
Vanessa M. McMahan A G , Aleks Martin B , Lindsay Garske B , Lauren R. Violette A , Michele P. Andrasik C D , Jared M. Baeten A C E , Caleb Banta-Green F and Joanne D. Stekler A C EA Department of Medicine, University of Washington, 325 9th Avenue, Seattle, WA 98104, USA.
B Project NEON, Seattle Counseling Service, 1216 Pine Street, Suite 300, Seattle, WA 98101, USA.
C Department of Global Health, University of Washington, 1510 San Juan Road, Seattle, WA 98195, USA.
D Fred Hutch, HIV Vaccine Trials Network, 1100 Fairview Avenue N, Seattle, WA 98105, USA.
E Department of Epidemiology, University of Washington, 1959 NE Pacific Street, HSB F-262, Seattle, WA 98195, USA.
F Alcohol & Drug Abuse Institute, University of Washington, 1107 NE 45th Street, Suite 120, Seattle, WA 98105, USA.
G Corresponding author. Email: vmcmahan@uw.edu
Sexual Health 16(2) 139-147 https://doi.org/10.1071/SH18060
Submitted: 10 April 2018 Accepted: 3 October 2018 Published: 11 February 2019
Abstract
Background: Cisgender men and transgender individuals who have sex with men (MSM/TG) and use methamphetamine are at elevated risk for HIV and have had limited pre-exposure prophylaxis (PrEP) uptake. The aim of this study was to quantify the knowledge and use of PrEP, identify barriers to PrEP use, and develop a targeted educational campaign to promote PrEP among MSM/TG who use methamphetamine. Methods: We conducted three consultations with peer educators of Project Needle and Sex Education Outreach Network (NEON) to develop and disseminate educational materials. We surveyed the peers’ HIV-negative contacts before and after this work to explore knowledge and opinions about PrEP and to assess the effect of our materials. Results: There were 221 respondents at baseline (August 2016) and 100 at follow-up (April–May 2017). At baseline, nearly all participants had ‘heard of PrEP’ (96%) and were insured (97%). However, only 3% had ever used PrEP. Peers suggested educational cards that included a definition of PrEP, adherence tips and that PrEP does not prevent other sexually transmissible infections. Peers distributed approximately 2560 educational cards. At follow-up, approximately half the respondents (53%) had seen the cards, and those who did reported significantly more agreement with the majority of the card messages about PrEP. Significantly more participants reported ever receiving PrEP at follow-up (21%; P < 0.001). There was a trend between seeing the cards and PrEP use (P = 0.053). Conclusions: Although we cannot be certain that the effect was due to our intervention, a greater number of the peers’ contacts reported receiving PrEP at follow-up, and those who saw our materials were more likely to agree with factual statements about PrEP. There is continued need for PrEP education for MSM/TG who use methamphetamine.
Additional keywords: HIV, meth, peer education, PrEP.
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