HIV Pre-exposure prophylaxis and buprenorphine at a drug detoxification center during the opioid epidemic: opportunities and challenges

abstract

Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) and buprenorphine decrease HIV acquisition. Between November, 2016 - July, 2017, we surveyed persons (N=200) at a drug detoxification center to assess their interest in PrEP and in buprenorphine, and to examine factors associated with such interests. Over the previous 6 months, 58% (117/200) injected drugs, 87% (173/200) used opioids, 50% (85/171) had condomless sex. Only 22% (26/117) of persons who injected drugs were aware of PrEP, yet 74% (86/116) and 72% (84/116) were interested in oral or injectable PrEP, respectively. Thirty-eight percent (47/125) of persons not receiving buprenorphine or methadone expressed interest in buprenorphine. After multivariable adjustment, Latinx ethnicity was associated with interest in PrEP (aOR: 3.80; 95% CI, 1.37–10.53), while male gender (aOR: 2.76; 95% CI, 1.21–6.34) was associated with interest in buprenorphine. Opportunities exist to implement PrEP and buprenorphine within drug detoxification centers.

Keywords: pre-exposure prophylaxis, persons who inject drugs, human immunodeficiency virus, medication for opioid use disorder, drug detoxification center