Table 3:
Correlates of current PrEP use (N=850)a
| Using PrEP | Unadjusted associations | Adjusted associations | ||||||
|---|---|---|---|---|---|---|---|---|
| Base modelb | Exploratory modelc | |||||||
| n | % | OR (95% CI) | p-value | aOR (95% CI) | p-value | aOR (95% CI) | p-value | |
| A priori covariates | ||||||||
| Region of residence | <0.001 | 0.260 | 0.676 | |||||
| King County | 123 | 25.2% | Reference | Reference | Reference | |||
| Other western Washington | 32 | 13.4% | 0.46 (0.30, 0.70) | 0.67 (0.41, 1.09) | 0.80 (0.45, 1.44) | |||
| Eastern Washington | 18 | 14.5% | 0.50 (0.29, 0.86) | 0.82 (0.44, 1.53) | 1.13 (0.53, 2.42) | |||
| Age | <0.001 | <0.001 | 0.043 | |||||
| 16 to 24 | 18 | 7.2% | Reference | Reference | Reference | |||
| 25 to 34 | 70 | 25.4% | 4.36 (2.51, 7.57) | 3.97 (2.19, 7.18) | 2.99 (1.43, 6.25) | |||
| 35 to 44 | 44 | 33.1% | 6.34 (3.48, 11.57) | 5.23 (2.66, 10.27) | 3.09 (1.33, 7.23) | |||
| 45 to 54 | 29 | 28.7% | 5.17 (2.71, 9.85) | 4.17 (2.03, 8.57) | 3.34 (1.32, 8.41) | |||
| 55 and older | 12 | 13.2% | 1.95 (0.90, 4.23) | 2.06 (0.87, 4.88) | 2.31 (0.83, 6.41) | |||
| Race/ethnicity | 0.717 | 0.784 | 0.858 | |||||
| Non-Hispanic white | 125 | 21.3% | Reference | Reference | Reference | |||
| Hispanic | 26 | 17.4% | 0.78 (0.49, 1.25) | 0.76 (0.45, 1.29) | 0.96 (0.50, 1.84) | |||
| Non-Hispanic black | 7 | 21.9% | 1.03 (0.44, 2.45) | 0.86 (0.32, 2.33) | 0.60 (0.19, 1.91) | |||
| Non-Hispanic other | 15 | 18.3% | 0.83 (0.46, 1.50) | 0.95 (0.47, 1.90) | 0.98 (0.44, 2.17) | |||
| Gay/homosexual identity | 160 | 22.3% | 2.68 (1.47, 4.87) | 0.001 | 1.90 (0.96, 3.75) | 0.063 | 1.50 (0.67, 3.39) | 0.326 |
| Education | <0.001 | 0.002 | 0.126 | |||||
| High school or less | 7 | 5.2% | Reference | Reference | Reference | |||
| Some college/vocational school | 41 | 15.0% | 3.23 (1.41, 7.41) | 2.00 (0.82, 4.89) | 1.50 (0.52, 4.33) | |||
| 4-year college or higher | 125 | 28.3% | 7.21 (3.28, 15.86) | 3.66 (1.55, 8.66) | 2.34 (0.83, 6.55) | |||
| Income | <0.001 | 0.319 | 0.534 | |||||
| Less than $15,000 | 7 | 7.1% | Reference | Reference | Reference | |||
| $15,000 to $29,999 | 13 | 12.6% | 1.90 (0.72, 4.98) | 2.07 (0.73, 5.86) | 1.76 (0.53, 5.87) | |||
| $30,000 to $49,999 | 34 | 23.1% | 3.95 (1.68, 9.33) | 2.80 (1.09, 7.14) | 2.84 (0.98, 8.29) | |||
| $50,000 to $99,999 | 59 | 22.8% | 3.88 (1.71, 8.82) | 2.37 (0.96, 5.86) | 1.96 (0.68, 5.62) | |||
| $100,000 or more | 54 | 27.3% | 4.93 (2.15, 11.30) | 2.90 (1.13, 7.46) | 1.84 (0.62, 5.50) | |||
| I prefer not to answer | 6 | 13.6% | 2.08 (0.65, 6.58) | 1.94 (0.54, 7.01) | 1.77 (0.39, 8.12) | |||
| WA State PrEP guidelines category | <0.001 | <0.001 | ||||||
| Not indicated | 13 | 4.1% | Reference | Reference | ||||
| Discussd | 69 | 27.2% | 8.81 (4.74, 16.37) | 10.14 (5.31, 19.37) | ||||
| Recommende | 91 | 33.0% | 11.62 (6.32, 21.36) | 13.91 (7.35, 26.34) | ||||
| Exploratory covariates | ||||||||
| Has health insurance | 170 | 21.9% | 6.74 (2.10, 21.67) | 0.001 | 6.16 (1.57, 24.14) | 0.009 | ||
| Diagnosis with rectal gonorrhea or syphilis | 27 | 41.5% | 3.11 (1.84, 5.26) | <0.001 | 3.35 (1.49, 7.49) | 0.003 | ||
| Anal sex role | <0.001 | 0.364 | ||||||
| No anal sex | 1 | 1.0% | 0.03 (0.00, 0.24) | 0.28 (0.03, 2.33) | ||||
| Exclusively bottom | 20 | 12.1% | 0.41 (0.21, 0.78) | 0.74 (0.31, 1.74) | ||||
| Versatile | 127 | 25.9% | 1.04 (0.63, 1.70) | 1.13 (0.58, 2.20) | ||||
| Exclusively top | 25 | 25.3% | Reference | Reference | ||||
| ≥10 anal sex partners | 83 | 60.6% | 10.64 (7.08, 16.00) | <0.001 | 2.99 (1.73, 5.14) | <0.001 | ||
| Current HIV-positive male partner | 30 | 41.1% | 3.09 (1.88, 5.10) | <0.001 | 3.63 (1.52, 8.69) | 0.004 | ||
| CAS with a partner who was not main/primary or whose HIV status was positive or unknown | 153 | 33.8% | 9.61 (5.89, 15.69) | <0.001 | 4.78 (2.63, 8.70) | <0.001 | ||
| Injection drug use | 5 | 9.3% | 0.38 (0.15, 0.97) | 0.044 | 0.33 (0.09, 1.19) | 0.092 | ||
| Methamphetamine use | 10 | 13.5% | 0.59 (0.30, 1.17) | 0.130 | ||||
| Poppers use | 77 | 41.4% | 4.18 (2.91, 6.01) | <0.001 | 1.91 (1.17, 3.13) | 0.010 | ||
| History of exchange sex | 1 | 3.1% | 0.12 (0.02, 0.89) | 0.038 | 0.32 (0.03, 3.02) | 0.321 | ||
| Perceived effectiveness of PrEP ≥90% | 153 | 36.0% | 11.39 (6.97, 18.61) | <0.001 | 4.83 (2.62, 8.89) | <0.001 | ||
Acronyms: OR, odds ratio; CI, confidence interval; aOR, adjusted odds ratio; CAS, condomless anal sex; PrEP, pre-exposure prophylaxis
This analysis is restricted to respondents who have never or are currently using PrEP and provided responses to all covariates;
The base model includes only a priori covariates (region, age, education, race/ethnicity, sexual orientation, income, and PrEP candidacy based on Washington state guidelines);
The exploratory model includes base model social and demographic variables and exploratory variables that were significant in biviariate analyses. The Washington state PrEP guideline category variable was not included in the exploratory model because it is derived from the specific HIV risk indicators included as exploratory covariates;
MSM who do not meet criteria for recommending PrEP and who reported CAS with a partner who is not main/primary, CAS with an HIV-positive or unknown status partner, diagnosis of urethral gonorrhea or rectal chlamydia, or injection drug use in the past 12 months, and those in ongoing sexual relationships with HIV-positive male partners who have been on ART ≥6 months and who are virologically suppressed;
MSM who reported a diagnosis of rectal gonorrhea or syphilis, use of methamphetamine or poppers, or history of exchange sex in the prior 12 months, and those in ongoing sexual relationships with HIV-positive male partners who are not on ART, on ART <6 months, or not virologically suppressed.