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Original research
Social determinants of self-reported pre-exposure prophylaxis use among a national sample of US men who have sex with men
  1. Brian A Chu1,
  2. Erick R Castellanos1,
  3. Manuel M Gonzales2,
  4. Thomas W Gaither3
  1. 1 David Geffen School of Medicine, Los Angeles, California, USA
  2. 2 Pediatrics, UCSF, San Francisco, California, USA
  3. 3 Urology, UCLA, Los Angeles, California, USA
  1. Correspondence to Dr Thomas W Gaither, Urology, UCLA, Los Angeles, CA 90095, USA; tgaithercastellanos{at}


Purpose Various disparities exist in HIV transmission among men who have sex with men (MSM). Pre-exposure prophylaxis (PrEP) has been shown to decrease the acquisition of HIV, but there is variation in uptake within the MSM population. We aim to characterise PrEP use and correlates of self-reported PrEP use in a large national sample of urban MSM in the USA.

Methods Using data from a geosocial-networking application, a national sample (n=3744) from the largest 50 metropolitan centres in the USA was obtained.

Results We found 18.1% (95% CI 16.8 to 19.3) of profiles reported using PrEP, with decreased reported PrEP use in younger MSM aged 18–24 years (adjusted OR (aOR)=0.5, 95% CI 0.3 to 0.7), obese MSM (aOR=0.5, 95% CI 0.3 to 0.9), black MSM (aOR=0.6, 95% CI 0.4 to 0.9) and MSM in the South (aOR=0.7, 95% CI 0.5 to 0.9).

Conclusion Significant disparities exist in PrEP reporting by age and among black, Southern US and obese MSM. More research is needed to better understand these disparities.

  • HIV pre-exposure prophylaxis
  • gay men
  • men
  • HIV
  • PrEP

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  • Handling editor Anna Maria Geretti

  • Contributors BAC, ERC and TWG collaborated in the writing of the manuscript. MMG aided in revision of the manuscript before submission. MMG and TWG were involved in the design of the study and collection of data. TWG and BAC chose directions for data analysis and TWG completed the statistical analysis.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as online supplementary information.