This oral poster session covers several studies on PrEP, PEP, and home HIV testing.  PEP involves a 28 day course of ARVs after an exposure to prevent HIV infection, and PrEP involves starting ARVs before exposure and continued during periods of risk.  PrEP with FTC/TDF and the home HIV test were both approved recently by the FDA.

 PrEP awareness among MSM participating in the National Behavioral Surveillance Study was low in Miami (15%) and Washington, DC (30%).  Almost half of MSM in Miami and about two-thirds in DC reported willingness to take PrEP, if available at no cost.  Non-injection drug use (OR = 0.59) was associated with decreased willingness to use PrEP in Miami, but increased willingness in DC (OR=1.67).  In DC, older age and having fewer sex partners was associated with decreased PrEP acceptability.

 Interest in PrEP was also assessed among 89 seronegative partners in a Ryan White HIV Clinic in South Carolina from 2010-2011.  The majority (94%) expressed willingness to use PrEP; however, 26% suggested they would be more likely to have unprotected sex with an HIV-positive partner while taking PrEP, and 27% suggested it would be difficult to take a daily pill.

Acceptability of intermittent PrEP was assessed in South African men and women using mixed methods.  The primary facilitator of PrEP uptake was its potential for nonconsensual use, while barriers included perception of antiretrovirals as treatment, stigma, and potential side effects and risk compensation.  iPrEP was favored over daily PrEP for perceived ease of use with fewer dosing days.  The median number of sex days/week was 2 (more likely on weekends), and approximately 2/3 of sex days were planned.

The feasibility and acceptability of home HIV rapid testing to screen sexual partners was evaluated in high-risk MSM in New York City (NYC).  A diverse sample of 27 men were provided test kits, and 101/124 partners agreed to testing -- 10 sexual partners were found to be HIV-infected, and no unprotected sex occurred with these partners.  The home HIV test was found to be highly acceptable, and some reported the home test kit shifted perceptions of risk and led to changes in risk practices.  Few social harms were reported, though audience members highlighted the importance of considering potential issues around stigma.

Experience with non-occupational post-exposure prophylaxis (nPEP) in a NYC based hospital was also presented.  Overall 116/134 (84%) of patients referred to the outpatient program completed the 4 week PEP course.  One participant seroconverted; this patient started nPEP 32 hours post-exposure.  A multi-disciplinary approach was helpful in coordinating care, follow-up, and supportive counseling.  The audience and panel discussed the importance of tolerability of PEP and PrEP regimens.

Qualitative data from focus groups with MSM in Rhode Island showed that while PrEP knowledge was low, the majority were willing to use PrEP.  Men reported a wide range of motivations and expected benefits with using PrEP.  Potential benefits included increased intimacy with partners, risk-reduction for HIV-negative partners, and empowerment of the community, and concerns included potential interactions with drug/alcohol, side effects, and concerns about confidentiality.  The FDA approval of PrEP was important for some men but not others, and was perceived to have a big impact on financing and insurance.