In 2019, black and Latino people who tested negative for HIV were the least likely to be referred to clinicians able to provide pre-exposure prophylaxis (PrEP), according to data published in Morbidity and Mortality. WeeklyReport. Despite accounting for 71% of all new HIV diagnoses that year, blacks and Latinos accounted for only 42% of PrEP referrals.
Shubha Rao, MPH, of the Centers for Disease Control and Prevention (CDC), and colleagues reviewed monitoring and evaluation test data from the 2019 National HIV Prevention Program. Data came from 60 health departments in State, local, and territorial that receive funding from the CDC as well as 29 CDC-funded community groups. They looked at how often people get tested for HIV and then receive referrals for PrEP. The study was done before the CDC updated its PrEP guidelines to suggest that clinicians talk about PrEP to all sexually active teens and adults and prescribe PrEP to anyone who asks for it.
Of the 2.3 million CDC-funded HIV tests performed in the United States in 2019, nearly a quarter, 23%, were for Latinos — a lower rate than testing for black or black Americans. whites, who accounted for 39% and 28% of HIV testers. , respectively. That’s lower than the rate of new HIV diagnoses among Latinos, who make up 18% of the US population but account for 29% of new diagnoses.
About 27% of Latinos who were tested for HIV had heard of PrEP. Latinos with transgender experience were the most aware of PrEP (69%), followed by cisgender Latino men (37%) and finally cisgender Latinas (15%). Black Latinos and Latinos of other non-white identities were more likely to have heard of PrEP, at 39% each, while white Latinos were the least likely, with only one in five being aware. Meanwhile, 64% of gay and bisexual Latino men had heard of PrEP, compared to 29% of Latinos who inject drugs and 22% of straight Latino men.
Interestingly, people were more likely to have heard of PrEP if they had been tested for HIV in a community setting rather than a clinic (35% versus 18%). Residents of US territories, including Puerto Rico, and the South were the least likely to be aware of PrEP, at 13% each.
Referrals to PrEP were roughly proportional for Caucasians who were tested for HIV in 2019: this group accounted for one in four HIV diagnoses and one in four referrals to PrEP for those tested. negative. By contrast, nearly half of new diagnoses (42%) were black people in 2019, but only one in five (21%) received recommendations for PrEP. Meanwhile, Latinos accounted for one in three new HIV diagnoses, but only one in five (22%) received PrEP referrals.
“Wider implementation of PrEP services among Hispanic people at risk of HIV infection is a critical strategy for EHE [‘Ending the HIV Epidemic’] initiative,” Rao and his colleagues wrote. “HIV prevention programs can help achieve the goals of the EHE Initiative by addressing individual, social and structural barriers to receiving PrEP services, collaborating with healthcare providers and other providers, expanding health care coverage, and implementing culturally and linguistically relevant strategies for Hispanic people.”
Click here to read the full study.
Click here to learn more about PrEP for HIV prevention and to read more health equity news.