Awareness and use of Truvada (tenofovir/emtricitabine) as pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) has risen significantly, but major uptake of the HIV prevention method is limited to a handful of cities, aidsmap reports. Researchers analyzed data from three nationwide cross-sectional Internet surveys of 10,097 MSM living in the United States. A total of 2,794 men were in the May to August 2012 survey, 3,096 men were in the December 2013 to May 2014 survey, and 8,406 men were in the October 2014 to March 2015 survey.

Findings were presented at the 2016 Conference on Retroviruses and Opportunistic Infections (CROI) in Boston.

Truvada was approved for HIV prevention in the United States in July 2012. Media outlets did not start covering PrEP significantly until the fall of 2013, after which there was a rapid upswing in coverage, not to mention social media chatter.

Awareness, willingness to use and actual use of PrEP all increased over time in the survey. The researchers aggregated the months in all the surveys and reported results from three phases: May 2012 to April 2014, May 2014 to October 2014, and November 2014 to March 2015. During those three phases, a respective 45 percent, 59 percent and 68 percent of men had heard of PrEP; a respective 39 percent, 50 percent, and 50 percent of men were willing to use PrEP; and a respective 0.5 percent, 2.4 percent and 4.9 percent of men said they had used PrEP during the previous 12 months.

Two percent of men living in rural areas reported using PrEP, compared with 3.5 percent in most urban areas. PrEP use was quite substantial among respondents living in San Francisco (17 percent), Washington, DC, (16 percent ), New York City (12 percent), Seattle (11 percent), and about 8 percent in Boston, Philadelphia, Chicago and Los Angeles.

Likely not coincidentally, health officials in the four cities with the highest level of use have instigated major pushes to promote PrEP among MSM. Washington State, for example, has a drug assistance program to help provide Truvada to at-risk residents.

The researchers did not find that African-American and white respondents to the survey had significantly different levels of awareness, willingness to use and actual use of PrEP.

Men at higher risk for HIV were more likely to use PrEP. A total of 6.7 percent of the men reporting 10 or more sexual partners during the previous 12 months said they had used PrEP, compared with 0.9 percent of men who had fewer than 10 partners. Also, 6.6 percent of men who were recruited to the survey through a GPS dating app reported PrEP use, compared with 1.2 percent of men recruited by other means. Lastly, 9.8 percent of men reporting a recent sexually transmitted infection said they had used PrEP, compared with 1.5 percent of men who did not report a recent STI.

To read the aidsmap article, click here.

To read the conference abstract, click here.