Background Internationally, approximately one out of every ten new HIV infections has previously been attributed to intravenous drug use (IVDU). PrEP compliance among people with intravenous drug use (PWID) may decrease new HIV infection. This study assessed perceptions of PrEP, risk for contracting HIV, and potential compliance with PrEP among PWID.

Methods Clients accessing IVDU mobile outreach van services, aged ≥18 years, completed anonymous self-report questionnaires about “Beliefs about Medicines” and “Perceived Risk of HIV” via iPad following informed consent.

Results Socio-demographics N=100, aged 18–63 years (50% <37 years), non-Hispanic White (56.5%), Hispanic (38.4%); male (59.6%), sex with men (28%), sex with women (51%), sex with both (16%), length of IVDU (1–9 years). Most separated/divorced (31.4%) or never married (47.5%); high school education or less (54.5%); currently (64%) or previously (75.8%) homeless; ever prison (54.5%) or arrested (89%); HIV testing (98%); currently HIV+ (2%). Risk Behavior: Money/drugs for sex (50%); uses condoms (30%), alcohol (93%), heroin (89%), marijuana (95%) prescriptions to get high (70%), LSD (69%), ecstasy (63%) cocaine (89%) meth (81%), crack (59%). Co-morbidities: Schizophrenia (7%), Anxiety (59%), Depression (60%), Hepatitis (36%), Diabetes (6%) and HTN (25%). Medication: Getting prescriptions easy (65.7%); visiting doctor monthly/blood drawn no big deal (80.8%); don’t like PrEP for long time (55.6%); concerned forget medications (53.6%), or medication side-effects (42.7%); think about HIV often (74.8%); HIV risk moderate/great (39.3%). Most medications addictive (43.5%); benefits out weight risks (57.6%); safe (47.5%); work better when taken regularly (60.6%); 46% requested PrEP clinic information.

Conclusions PWID perceived high-risk for HIV. High levels of co-morbidities, substance use, limited HIV protective behavior and homelessness existed. Positive attitudes toward and interest in medication use for disease prevention and concerns regarding long-term medication or forgetting medications. PrEP adherence among PWID presents clinical challenges. Addressing risks, co-morbidities and inconsistent use of PrEP may optimize adherence.

Disclosure No significant relationships.