Pre-exposure Prophylaxis (PrEP) Awareness and Use Among Cisgender Men Who Have Sex With Men (MSM) and Use Methamphetamine in Three Western US Cities

Published In

Journal of The American Sexually Transmitted Diseases Association

Document Type


Publication Date




In the United States, cisgender men who have sex with men (MSM) who use methamphetamine are at substantial risk of HIV and can benefit from pre-exposure prophylaxis (PrEP).


We used data from the National HIV Behavioral Surveillance (NHBS) 2017 survey from Seattle, WA; Portland, OR; and Denver, CO to estimate PrEP awareness and use in the past 12 months among MSM who use methamphetamine. We then compared these estimates to participants who do not use methamphetamine but meet other criteria for PrEP use (i.e., condomless anal sex or a bacterial sexually transmitted infection). We explored reasons for not using PrEP and challenges using PrEP.


Of the 1,602 MSM who participated in the 2017 NHBS survey in Seattle, WA; Portland, OR; and Denver, CO, 881 met inclusion criteria for this study, of whom 88 (10%) reported methamphetamine use in the past 12 months. Most (95%) participants had heard of PrEP, and 35% had used it in the past 12 months. PrEP awareness was lower among MSM who used methamphetamine (p=.01), but use was not different (p=.26). Among those who had not used PrEP, the most common reason for not using it was not thinking one’s HIV risk was high enough (50%). MSM who used methamphetamine were more likely to report that they were not sure PrEP would prevent them from getting HIV (38% vs 19%, p=.002).


These results highlight the need for continued efforts to educate and promote PrEP uptake among MSM, particularly those who use methamphetamine.


© Copyright 2020 American Sexually Transmitted Diseases Association



Persistent Identifier