Long-acting Injectable Pre-Exposure Prophylaxis Preference for Persons Who Use Drugs and are Involved with the Criminal Legal System.

BACKGROUND: Criminal legal involved (CLI) persons who use drugs (PWUD) are at high risk of exposure to HIV, yet few initiate pre-exposure prophylaxis (PrEP). Understanding interest in PrEP and the different formulations of PrEP may improve uptake in this population. METHODS: Participants were CLI adults aged 18 or older, used opioids and/ stimulants, tested negative for HIV and met CDC PrEP eligibility criteria. Characteristics of persons interested in PrEP were compared to those who were not interested in PrEP at baseline. Among those interested in PrEP, characteristics were compared for those who preferred long-acting injectable (LAI) versus oral PrEP. RESULTS: Of 566 persons enrolled, 35.1% (N=199) were interested in PrEP; of those, 60.8% (N=121) preferred LAI vs 39.1% (N=78) oral PrEP. PrEP interest was greater in persons from Texas (50%) vs Connecticut (18.3%). A significantly higher odds of being interested in PrEP was associated with having a methamphetamine use disorder and a higher self-perceived risk of HIV; and a history of sharing IDU equipment was associated with a higher odds of being interested in LAI vs. oral PrEP. CONCLUSIONS: Among CLI PWUD eligible for PrEP, persons in TX, were more interested in PrEP compared to persons in CT. Persons with a methamphetamine use disorder and a higher self-perceived risk of HIV were predictors of PrEP interest and sharing IDU equipment was a predictor of interest in LAI vs. oral PrEP. More research on patient choice and shared decision making should be included to improve PrEP initiation.