Inequities in PrEP use according to Medicare status in a publicly funded sexual health clinic; a retrospective analysis
Aaron Coleman A , Ben John Maslen B and Rosalind Foster A C *A
B
C
Abstract
New HIV diagnoses continue to disproportionately affect overseas-born men who have sex with men (MSM). A retrospective study of all pre-exposure prophylaxis (PrEP)-eligible MSM attending Sydney Sexual Health Centre for the first time in 2021 analysed self-reported PrEP-use, PrEP prescribed at the initial consult, and PrEP taken during 2021 using binomial logistic regression models. A total of 1367 clients were included in the analysis, 716 (52.4%) were born overseas and 414 (57.8%) were Medicare-ineligible. Medicare-ineligible clients were less likely to be on PrEP at initial visit (OR 0.45, 95% CI 0.26–0.77). This study suggests inequities in PrEP access and/or awareness in Medicare-ineligible MSM in Australia.
Keywords: HIV/AIDS, HIV prevention, pre-exposure prophylaxis, primary care, public health.
References
1 King J, McManus H, Kwon A, Gray R, McGregor S. HIV, viral hepatitis and sexually transmissible infections in Australia: annual surveillance report 2022. Sydney: The Kirby Institute, UNSW Sydney; 2022. Available at http://doi.org/10.26190/sx44-5366
2 Gunaratnam P, Heywood AE, McGregor S, Jamil MS, McManus H, Mao L, et al. HIV diagnoses in migrant populations in Australia—a changing epidemiology. PLoS ONE 2019; 14(2): e0212268.
| Crossref | Google Scholar | PubMed |
3 Blackshaw LCD, Chow EPF, Varma R, Healey L, Templeton DJ, Basu A, et al. Characteristics of recently arrived Asian men who have sex with men diagnosed with HIV through sexual health services in Melbourne and Sydney. Aust N Z J Public Health 2019; 43(5): 424-428.
| Crossref | Google Scholar | PubMed |
4 Broady T, Chan C, Bavinton B, Mao L, Molyneux A, Delhomme F, et al. Gay community periodic survey: Sydney 2021. Sydney: Centre for Social Research in Health, UNSW Sydney; 2021. Available at http://doi.org/10.26190/nr8p-at84
5 MacGibbon J, Lea T, Ellard J, Murphy D, Kolstee J, Power C, et al. Access to subsidized health care affects HIV pre-exposure prophylaxis (PrEP) uptake among gay and bisexual men in Australia: results of national surveys 2013–2019. J Acquire Immune Defic Syndr 2021; 86(4): 430-435.
| Crossref | Google Scholar |
6 Tieosapjaroen W, Zhang Y, Fairley CK, Zhang L, Chow EPF, Phillips TR, et al. Improving access to oral pre-exposure prophylaxis for HIV among international migrant populations. Lancet Public Health 2023; 8: e651-e658.
| Crossref | Google Scholar | PubMed |
7 Sudarto B, Chow EPF, Medland N, Fairley CK, Wright EJ, Armishaw J, et al. “How PrEPared are you?”: knowledge of and attitudes toward PrEP among overseas-born and newly arrived gay, bisexual, and other men who have sex with men in Australia. Front Public Health 2022; 10: 946771.
| Crossref | Google Scholar | PubMed |
8 Phillips TR, Medland N, Chow EPF, Maddaford K, Wigan R, Fairley CK, et al. Newly arrived Asian-born gay men in Australia: exploring men’s HIV knowledge, attitudes, prevention strategies and facilitators toward safer sexual practices. BMC Infect Dis 2022; 22: 209.
| Crossref | Google Scholar | PubMed |