Pre-Exposure Prophylaxis Awareness and Demand Creation: Overlooked Populations and Opportunities to Move Forward.

Abstract

Background: Pre-exposure prophylaxis (PrEP) for HIV prevention has been available since 2012, but uptake remains disappointing and inequitable. Furthermore, there is little evidence on the effectiveness of interventions to increase PrEP demand among priority populations in the United States. The objectives of this article were to describe how consumer perceptions of PrEP vary by distinct population groups and identify gaps in PrEP awareness, knowledge, and interest.

Methods: We synthesized evidence-based interventions to improve demand for PrEP in populations heavily burdened by HIV. The focus centered on consumer factors, how people's awareness of PrEP, especially people who are likely to benefit, influences PrEP uptake.

Results: Awareness and equity in PrEP use among vulnerable populations in the United States remain low because of both demand-side obstacles and accessibility challenges. Designing an effective package of interventions to increase demand for PrEP involves integrating strategies that address awareness, knowledge, interest/motivation, and access.

Conclusions: The underutilization of PrEP among the 1.2 million individuals who could benefit from it highlights the need for effective demand creation to reduce disparities. To effectively increase awareness of the benefits of PrEP requires consideration of the characteristics of the target population and the structural inequalities that contribute to PrEP-related disparities. Demand creation activities can increase awareness, correct misconceptions, provide knowledge, and help people decide whether PrEP is a good fit for them. The utilization of implementation science frameworks is essential to address demand generation and supply-side barriers to PrEP use.