Brief Report: Behavioral Readiness for Daily Oral PrEP in a Diverse Sample of Gay, Bisexual, and Other Men Who Have Sex With Men Who Have Not Been Offered PrEP by a Provider

BACKGROUND

Daily oral pre-exposure prophylaxis (PrEP) use among gay, bisexual, and other men who have sex with men (GBMSM) remains suboptimal. Assessing behavioral readiness for PrEP use among GBMSM who can benefit and offering PrEP may increase uptake among GBMSM. We measured 4-item readiness for taking PrEP among GBMSM who have not been offered PrEP by a provider.

METHODS

GBMSM in Atlanta, Chicago, and Raleigh-Durham reporting recent condomless anal sex were assessed for "readiness" to discuss PrEP with a provider, test for HIV, take a daily pill, attend provider appointments, and a 4-component composite score for PrEP readiness. χ 2 tests and multivariable logistic regression were applied to examine factors associated with readiness to use PrEP.

RESULTS

Study sample (n = 187) was 51% Black/African American, 15% Hispanic/Latino, 30% identified as bisexual or straight or other, and 29% had no health insurance. In total, 55% said they were ready to discuss PrEP with a provider, 88% were ready to get an HIV test, 45% were ready to take a daily pill, 48% were ready to attend appointments, and 37% reported overall PrEP readiness. Having no health insurance was associated with readiness for a daily pill [adjusted odds ratio (AOR) = 2.78, confidence interval (CI) = 1.34-5.78] and 4-item PrEP readiness (AOR = 2.34, CI = 1.13-4.85). Self-identification as gay (vs bisexual/straight) was associated with readiness to discuss PrEP (AOR = 2.14, CI = 1.05-4.36).

CONCLUSIONS

Only 37% of GBMSM with recent condomless anal sex were ready for PrEP based on the 4-item readiness. Readiness may differ based on sexual identity, insurance status, and other characteristics. Efforts are needed to increase readiness across behavioral components of PrEP use.