Concordance Between PrEP Modality Preference and Current Use Among Cisgender MSM Restricted; Files Only
Parker, Joshua (Spring 2026)
Abstract
Introduction: While multiple pre-exposure prophylaxis (PrEP) modalities are available in the United States, little is known about whether individuals can access their preferred modality, especially among people experiencing housing instability. Discordance between an individual’s preferred and current PrEP modality may impact uptake and adherence.
Methods: This study used data from the 2021 to 2024 cycles of the American Men’s Internet Survey (AMIS) to examine the association between housing status and PrEP modality concordance. Characteristics of MSM currently on PrEP were summarized, and odds ratios were calculated for the associations between housing instability and PrEP modality concordance.
Results: Among the participants, 5% (321/ 5929) reported experiencing housing instability in the past 12 months. 36% of MSM currently taking PrEP reported concordant PrEP preferences with their current PrEP modality. Unstably housed individuals had a lower odds of concordant PrEP modalities (OR = 0.59, 95% CI: 0.45 - 0.77). Unstably housed participants had a lower odds of preferring daily oral PrEP compared to stably housed individuals (OR = 0.51, 95% CI: 0.36 - 0.70) and more likely to prefer on-demand (OR = 2.08) and injectable (OR = 1.62 over stably housed individuals. Individuals’ current PrEP modality was the strongest predictor of concordance; injectable PrEP users had 13 times the odds of concordance (OR = 13.2, 95% CI: 8.04–23.1) and on-demand users had 5 times the odds of concordance (OR = 5.36, 95% CI: 3.87–7.56) compared to daily oral PrEP users.
Conclusion: Housing instability was negatively associated with participants' concordance between their preferred and current PrEP modality. Most stably housed participants preferred their current PrEP modality, whereas unstably housed individuals preferred lower-burden alternatives (injectable or on-demand). Expanding PrEP delivery must ensure providers routinely assess housing instability and modality preferences, particularly within vulnerable populations.
Table of Contents
Introduction 1
Methods 4
Analytical Framework 4
Data Source and Study Eligibility 4
Study Participants 5
Measures 5
Analysis Plan 6
Results 7
Discussion 10
References 14
Tables 17
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File download under embargo until 21 May 2028 | 2026-04-23 16:31:48 -0400 | File download under embargo until 21 May 2028 |
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