In a groundbreaking exploration of the factors influencing HIV transmission among sexual and gender minority individuals, a team of researchers from the CUNY Graduate School of Public Health and Health Policy (CUNY SPH) and the CUNY Institute for Implementation Science in Population Health (CUNY ISPH) conducted an extensive national cohort study.
Unveiling Barriers to PrEP Effectiveness
The research aimed to identify the hurdles that prevent many at-risk individuals from fully embracing HIV Pre-Exposure Prophylaxis (PrEP), a highly effective preventive measure. Despite being available for over ten years, the uptake of PrEP among those who stand to benefit the most has been slow and unequal, leading to disparities in usage rates among different racial and ethnic groups.
Challenges in PrEP Utilization
Obtaining and maintaining PrEP pose significant challenges, including regular medical appointments, mandatory blood tests, and coordination with pharmacies. Consistent adherence to PrEP is further complicated by factors such as job security, reliable transportation for healthcare visits, and housing instability. Substance abuse, especially methamphetamine, not only increases the risk of HIV infection but also hinders adherence to PrEP.
The T5K Cohort Investigation
The Together 5,000 (T5K) cohort study enrolled 6,059 cisgender men and transgender individuals who have sex with men and monitored them from 2017 to 2022. Participants who were clinically recommended for PrEP but were not using it initially were tracked over the four-year period.
Key Findings
The study observed a high rate of HIV infections over the four years, highlighting the critical role of PrEP in preventing HIV transmission. Individuals adhering to PrEP showed an 80% lower risk of contracting HIV, underscoring the importance of adherence to the medication. Concerningly, individuals who started and then stopped taking PrEP had a higher risk of infection compared to those who never initiated the treatment. The use of methamphetamine in the previous year significantly increased the risk of acquiring HIV, particularly affecting sexual and gender minority individuals from marginalized communities.
Call to Action
Lead author of the study, Professor Christian Grov from CUNY SPH, emphasized the urgent need for further research on the connection between methamphetamine use and HIV transmission. Additional resources are crucial to support individuals struggling with meth use and address the urgent issue of HIV spread within the sexual and gender minority community. The study's outcomes underscore the importance of tailored interventions and support systems to enhance PrEP effectiveness and address the ongoing HIV crisis. For more information on the study, please refer to the Journal of the International AIDS Society.