Changes in Awareness of Human Immunodeficiency Virus (HIV) Pre-exposure Prophylaxis (PrEP) in High-Risk Populations of Men Who Have Sex With Men (MSM) in Denver Colorado in 2008, 2011, and 2014: Implications for Implementation

Background. PrEP is a highly effective primary prevention strategy for HIV infection. The two-drug combination emtricitabine and tenofovir, taken as a once-daily pill, was approved by the FDA in 2012, following results of multiple international clinical trials. The success of PrEP as a primary HIV prevention strategy depends upon its acceptance and use in population at high risk for HIV. In the US, these include MSM, people who inject drugs, and heterosexuals with high-risk behaviors. This study examines the changes in awareness, acceptability and perceived effects of PrEP on high-risk sexual behavior by MSM from 2008 to 2014. Methods. The National HIV Behavioral Surveillance System (NHBS), funded by the Centers for Disease Control (CDC), is an ongoing survey targeting populations at high risk for HIV in multiple urban centers in 3 year cycles. PrEP questions were included in MSM surveys in 2008, 2011, and 2014. MSM in Denver, Colorado were recruited according to venue-based, time-sampling methods used in NHBS protocols. MSM self-reporting as HIV-negative and sexually active within the past 12 months were questioned about PrEP awareness. PrEP was described as a highly effective once-daily pill to prevent HIV infection with few/no side effects. Respondents were asked about willingness to use PrEP as described, and anticipated changes in condom use and number of sexual partners if taking PrEP. The 2008, 2011, and 2014 samples were compared using chi-squared statistics. Results. Among MSM surveyed (2008: N = 421, 2011: N = 461, 2011: N = 451) PrEP awareness increased from 21% to 28% to 46%, respectively (p < 0.001 for change from 2011 to 2014). Willingness to use PrEP remained steady at over 60% in each survey year. Anticipated changes in condom use and number of sexual partners did not change significantly over each year (2008: 82%/92%, 2011: 78%/85, 2014: 78%/89%, p > 0.05). Conclusion. Awareness of PrEP as an effective HIV prevention strategy for HIV has increased but lagged behind studies demonstrating its effectiveness in this MSM community. A marked increase in PrEP awareness among MSM most at risk for HIV infection was not associated with changes in current or anticipated high risk behaviors. Further research to increase awareness and willingness to use PrEP is needed. Disclosures. All authors: No reported disclosures.