Interest in Long-Acting PrEP by Methamphetamine Use Among Men Who Have Sex with Men in Four Western US Cities

Methamphetamine use is a driver of HIV among men who have sex with men (MSM) and is associated with suboptimal adherence to daily, oral PrEP. Long-acting PrEP may be a promising alternative. We analyzed data from the 2023 National HIV Behavioral Surveillance survey in four western cities to assess interest in long-acting PrEP among HIV-negative MSM participants. Of 1,450 participants, 7% used methamphetamine in the past 12 months. Two-thirds were interested in long-acting PrEP (68%); with no difference in interest (χ² = 1.4, p = 0.24) or prior PrEP use (χ² = 0.56, p = 0.46) by methamphetamine use. A larger proportion of participants unaware of PrEP had used methamphetamine (20% vs. 7%, χ² = 10.7, p < 0.01). Among those interested, a plurality preferred biannual injection (47%). We found high interest in long-acting PrEP and similar PrEP use rates, but lower awareness, among participants who used methamphetamine. However, our sample may not have been representative of those with higher-risk methamphetamine use.