Background: Drug-involved men under community supervision are at elevated risk for HIV acquisition. There is an urgent call to action to develop, test and implement novel HIV prevention interventions that reduce HIV transmission. The study aims to examine the acceptability for using pre-exposure prophylaxis (PrEP) among drug-involved men under community supervision and their main female sexual partners in New York City.
Methods: Utilizing 12-month data of a couple-based HIV study for drug-involved men under community supervision and their main sexual partners, 460 participants met inclusion criteria of the study (aged 18 or older, in relationship for 3 or more months, reported unprotected sex in the past 90 days, reports drug use or enrolled in a drug treatment program in the past 12 months) and were randomized. 390 participants (85%), completed the 12-month follow-up assessments. We collected data on PrEP pertinent question(s): (1) likelihood to use PrEP as a form of HIV prevention; (2) willingness to use PrEP if made available for daily use; (2) readiness and willingness to disclose use of daily PrEP to their main partner; and (3) using condoms alongside daily PrEP. Responses were rated as “very unlikely”, “unlikely”, “somewhat likely” and “very likely”.
Results: Of the sample, 51% identified as male (N=196) and 49% identified as female (N=194). The average age was 35 (SD12.98). The majority identified as Black/African American (72.4%). Almost sixty percent (59.1%) were single or never married. 68% were unemployed and 40.4% earned less than $400 per month. Nearly one-fourth (25.9%, n=102) of the participants were very likely to use PrEP as an HIV prevention method; at least one-third of the participants reported being very willing to disclose using PrEP to their main sexual partner and were similarly highly likely to use PrEP as a daily medication (38.3% and 38.8%; n= 151; 153 respectively).
Conclusions: Findings suggest that PrEP may be an acceptable and useful form of HIV prevention among drug-involved men under community supervision with their sexual partners. However, there is an urgent need for more PrEP studies to better understand the barriers and attitudes to PrEP and integrated HIV prevention and treatment among this vulnerable population.

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