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AIDS Behav. 2018 May 9. doi: 10.1007/s10461-018-2139-9. [Epub ahead of print]

Poppers and PrEP: Use of Pre-exposure Prophylaxis Among Men Who Have Sex with Men Who Use Inhaled Nitrites.

Author information

1
Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, 227 East 30th Street, 6th Floor, New York, NY, 10016, USA. Horace.Hambrick@nyumc.org.
2
Department of Population Health, Spatial Epidemiology Lab, New York University School of Medicine, 227 East 30th Street, 6th Floor, Cube 628A, New York, NY, 10016, USA. Horace.Hambrick@nyumc.org.
3
Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, 227 East 30th Street, 6th Floor, New York, NY, 10016, USA.
4
Departments of Medicine and Public Health Sciences, University of Chicago School of Medicine, and Chicago Center for HIV Elimination, 5841 S. Maryland Avenue, MC 5065 Room L-330, Chicago, IL, 60637, USA.
5
Departments of Medicine and Global Health and Population, Harvard Medical School and Harvard School of Public Health, and Fenway Health, 1340 Boylston Street, Boston, MA, 02215, USA.
6
Department of Public Health Sciences, Univeristy of Miami, 1120 NW 14th St., Office 1005, Miami, FL, 33136, USA.

Abstract

Men who have sex with men (MSM) commonly use inhaled nitrites, or poppers, though their use is a risk factor HIV seroconversion. Pre-exposure prophylaxis, or PrEP, is effective for HIV prevention, but is not widely used, and little is known regarding PrEP use and acceptability among MSM who use inhaled nitrites. We surveyed 580 MSM in Paris, France in 2016 about popper use, sexual behaviors including condomless anal intercourse (CAI), serosorting, and sexual positioning, PrEP use, PrEP candidacy, and interest in alternate PrEP delivery modalities. We included 444 HIV negative participants for the current study. 46.2% reported popper use in the prior 3 months. Using multivariate adjusted logistic regression, we found that popper users were more likely than non-users to consider themselves candidates for PrEP [adjusted relative risk ratio (aRRR) = 2.73; 95% CI 1.54-4.83], but they were not more likely to be current (aRRR = 1.54; 95% CI 0.71-3.33) or past (aRRR = 1.37; 95% CI 0.44-4.28) PrEP users. Mediation analyses indicated that increased CAI and serosorting partly explained the relationship between popper use and PrEP candidacy. There was considerable interest in alternate proposed PrEP delivery modalities, particularly long-acting injectable PrEP [adjusted risk ratio (aRR) = 1.43; 95% CI 1.15-1.79].

KEYWORDS:

HIV prevention; Inhaled nitrites; Men who have sex with men; Poppers; PrEP

PMID:
29744767
PMCID:
PMC6226362
[Available on 2019-11-09]
DOI:
10.1007/s10461-018-2139-9

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