Familiarity with PrEP for HIV prevention in Allegheny County, Pennsylvania, 2024

Background: PrEP (pre-exposure prophylaxis) is a highly effective tool for preventing HIV and plays a vital role in efforts to end the HIV epidemic. However, community familiarity varies widely across demographics and subgroups most impacted. Assessing regional PrEP familiarity may help guide local prevention efforts. Methods: We conducted a secondary analysis using data from a 26-question survey (which employed a mixed-methods online and in-person sampling approach) that collected information on familiarity with and barriers to accessing PrEP among Allegheny County, Pennsylvania residents from June through July 2024. Bivariate and multivariate analyses assessed differences by demographics and HIV risk factors in PrEP familiarity, having ever been recommended PrEP, and having ever used PrEP. Results: Of the 1,334 respondents included in the analysis, median age was 39 years and 71.5% were white. Overall, 46.0% of the respondents were familiar with PrEP, 14.6% somewhat familiar, and 39.4% not familiar. Most men who have sex with men (78.8%), non-cisgender individuals (87.0%), individuals who participate in in-person sex work (75.6%), and those recently diagnosed with a sexually transmitted infection (81.6%) were familiar with PrEP. Familiarity was lower among people who inject drugs (53.5%). A multivariate analysis revealed injection drug use (odds ratio: 1.25, 95% confidence interval: 1.14-1.38) was significantly associated with familiarity when controlling for age, race, ethnicity, gender, and sexual orientation. Conclusions: PrEP familiarity varied significantly by subgroup, highlighting the need for targeted education and outreach. Continued, subgroup-specific tailored messaging is essential, especially as the HIV epidemic evolves and new prevention options become available.