The Pre-exposure Prophylaxis (PrEP) Care Continuum Among English-Speaking Latino Sexual Minority Men in the United States (2014–2020)

Abstract

Background: There is limited understanding of the pre-exposure prophylaxis (PrEP) care continuum specific to Latino/x gay, bisexual, and other sexual minority men (SMM) that encompasses the population residing outside of large metropolitan or urban areas. Setting: We examined trends and characteristics associated with the PrEP care continuum with data from the 2014–2020 cycles of the American Men's Internet Survey, an annual online cross-sectional behavioral survey of cisgender SMM in the United States. Methods: We calculated PrEP continuum outcomes overall and by year among Hispanic/Latino SMM (n = 9010). We used generalized estimating equations with Poisson links to examine (1) temporal trends (2014–2020) in each step of the PrEP continuum and PrEP use in the past year stratified by PrEP eligibility and (2) correlates of each step of the PrEP continuum in 2020 using multivariable models. Results: Among 2283 Latino SMM in 2020, 84% reported PrEP awareness, 30% discussed PrEP with a provider, 15% used PrEP in the past year, and 12% were currently using PrEP. PrEP awareness increased from 52% in 2014 to 84% in 2020; and PrEP use in the past year increased from 4% in 2014 to 15% in 2020. In the multivariable models, age and PrEP eligibility were associated with PrEP use in the past year, and urban–rural classification was associated with current PrEP use. Conclusions: While most of the Latino SMM are aware of PrEP, significant gaps remain in this population in discussing PrEP with a provider and using PrEP that require tailored strategies to enhance access to HIV prevention services.