Psychosocial correlates of awareness of HIV pre-exposure prophylaxis (PrEP) among persons who inject drugs in Northeast Georgia

Despite Georgia having one of the highest rates of new HIV diagnoses in the United States, uptake of HIV pre-exposure prophylaxis (PrEP) remains critically low. We assessed the psychosocial correlates associated with PrEP awareness among persons who inject drugs (PWID) living in Northeast Georgia. Data were collected from 173 adult (≥18 years) HIV-negative PWID. PrEP awareness was elicited by the question, "Have you ever heard of PrEP?" (Yes/No). Covariates include age, gender, sexual orientation, race/ethnicity, education, health insurance, HIV testing, syringe services program (SSP) attendance, psychological stress, resilience, risky sexual and injection behaviors, HIV information seeking, and primary drugs used. Less than half (47.4%) of participants were aware of PrEP. Most participants were interested in asking for PrEP information from providers, obtaining prescriptions, and taking PrEP. In the multivariable analysis, the odds of PrEP awareness were higher among PWID who had higher resilience (adjusted OR: 1.06, 95%CI: 1.02-1.10), ever attended an SSP (adjusted OR: 2.53, 95%CI: 1.21-5.63) and performed sexualized drug use in the last year (adjusted OR: 2.38, 95%CI: 1.01-5.63). PrEP awareness is the first step in the HIV prevention continuum, influencing initiation, use, and persistence. A resilience-based approach in SSP settings may effectively increase PrEP awareness among PWID.