Growth in Proportion and Disparities of HIV PrEP Use Among Key Populations Identified in the United States National Goals

Systematic Review and Meta-Analysis of Published Surveys

Emiko Kamitani, PhD; Wayne D. Johnson, PhD; Megan E. Wichser, MPH; Adebukola H. Adegbite, MPH; Mary M. Mullins, MSLS; Theresa Ann Sipe, PhD


J Acquir Immune Defic Syndr. 2020;84(4):379-386. 

In This Article


This study found increased proportions of self-reported PrEP use and PrEP disparities among key populations identified by the national HIV goals as vulnerable to HIV infection in the United States. MSM and Hispanic/Latinos were more likely to report having ever used PrEP than other key populations (ie, blacks, PWID, youth, people in the Southern United States, and transgender women), and the proportions had increased since 2015. On the other hand, people in the Southern United States and youth had lower levels of PrEP use and did not demonstrate PrEP use growth in recent years. Furthermore, few studies focused on PWID and non-MSM subgroups, such as black women and non-MSM PWID. One of the goals introduced in the most recent CDC's Division of HIV/AIDS Prevention's (DHAP) Strategic Plan 2017–2020 is to reduce HIV-related disparities and health inequity.[33] PrEP may help to reduce disparities in HIV incidence rates if accessible to populations with the highest disparities. This study indicates that disparities in PrEP access/availability may exist, which could contribute to or exacerbate existing disparities in HIV acquisition. Culturally tailored approaches targeting these most vulnerable populations, in addition to approaches targeting providers serving these populations, are needed to increase PrEP access and use, thereby reducing disparities in HIV acquisition.