Pre-Exposure Prophylaxis (PrEP) is an HIV prevention strategy based on the daily use of the antiviral drug Truvada. This is a pill combining two medicines (tenofovir and emtricitabine), which is taken daily to prevent the HIV virus from establishing a permanent infection.
PrEP is recommended by the World Health Organization and the US Centers for Disease Control and Prevention (CDC) to HIV-negative people who are especially exposed to the risk of HIV infection, including Men who have Sex with Men (MSM) and injection drug users. PrEP is known to reduce the risk of HIV infection by up to 92%, but its effectiveness strongly depends on how consistent an at-risk person is in taking the drug. (Continues after figure.)
Identification, engagement, and retention of at-risk individuals in PrEP care are increasingly seen as key to reducing HIV incidence, including by the US National Institutes of Health (NIH). To benefit from PrEP, however, people must go through a sequence of multiple steps known as the PrEP care continuum or cascade. This includes developing awareness of PrEP, linking to PrEP programs and services, screening as a PrEP candidate, receiving a PrEP prescription, consistently taking the PrEP medication, and achieving longer-term adherence and persistence in the overall PrEP program.
How do people initiate and move forward in the PrEP cascade? What social and cultural factors predict PrEP advancement? Can people’s social networks help us explain why some people initiate and persist in the PrEP continuum while others don’t?
Starting in early 2018 I’ll participate in an NIH-funded project that attempts to answer some of these questions, with PI Mariano Kanamori at the University of Miami Miller School of Medicine. We’ll look in particular at social networks and PrEP care in the Latino community in Miami-Dade county, thanks to support by the Adelante program of the Centers for AIDS Research.
The research will examine the association between characteristics of friendship and sexual networks and progress in the PrEP cascade among Latino MSMs. The broader goal is to identify some of the sociocultural factors that can be leveraged to promote HIV prevention, particularly in underserved minority populations. Looking forward, this could lead to develop network-based interventions to promote PrEP care in both immigrant minorities and mainstream populations.