Authors
Ryan Edgerton, Cristian Chandler, Allison Wilhelm, April Pettit, Carolyn Audet, Peter Rebeiro, Loren Ginn, Latrice Pichon, Rabee Haq, John Rodney, Robert Lyle Cooper
Published in
AIDS care. Pages 1-12. Oct 07, 2026. Epub Oct 07, 2026.
Abstract
People who inject drugs (PWID) in the Southern United States face elevated HIV risk due to limited testing, constrained PrEP access and structural barriers to harm reduction. Within syringe service programs (SSPs), universal PrEP delivery may be inefficient. Key subgroups - individuals engaged in sex work, men who have sex with men (MSM) and people sharing syringes - have distinct risk profiles, awareness, and motivation that influence PrEP uptake. This study identifies high-yield groups for risk-stratified PrEP delivery in SSPs. We conducted a cross-sectional survey of 685 PWID attending SSPs in Tennessee. Measures included demographics, drug use, sexual risk, PrEP awareness, willingness to initiate PrEP and objective HIV risk using the ARCH tool. Multivariate logistic regression identified predictors of willingness. Overall, 63.1% reported willingness to use PrEP. Willingness was highest among those engaged in sex work (80-81%; adjusted OR 2.5-3.3, p < 0.05). MSM had greater awareness but no higher adjusted willingness. Syringe sharers had the highest objective risk yet lower awareness and willingness, indicating a high-risk but harder-to-engage group. These findings highlight the potential value of tailoring PrEP promotion strategies within SSPs. While individuals engaged in sex work may be well positioned for rapid PrEP initiation, additional efforts may be needed to improve PrEP uptake among those who report syringe sharing.
PMID:
42842899
Bibliographic data and abstract were imported from PubMed on 08 Oct 2026.
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