Abstract
BACKGROUND: People who inject drugs (PWID) are at increased risk for human immunodeficiency virus (HIV). Women who inject are a particularly vulnerable group. Preexposure prophylaxis (PrEP) is effective, but access and uptake has been limited. This study evaluated interest and concerns around oral and injectable PrEP among PWID based on gender. METHODS: This cross-sectional analysis of survey data from 8 sites in the United States (n = 284) assessed attitudes and interest in PrEP. Demographics, HIV risk behaviors, and attitudes toward PrEP were described overall and by self-identified gender (female vs male). RESULTS: Participants completed the PrEP survey between 2019 and 2021. The mean (standard deviation) age was 44.6 (11.4) years, 29% female, and 66% White. Mean self-perceived HIV risk score (0-10) was 2.3 (standard deviation 2.0). Interest in injectable PrEP (49.5%) was significantly higher than interest in daily oral PrEP (20.1%) ( P ≤ 0.001). The most cited concerns were medication side effects (53%) and medication interactions (39.2%). Perceived HIV risk and PrEP concerns were not significantly different between genders. CONCLUSIONS: There was high interest in injectable PrEP, particularly among females. The top concerns were medication side effects and medication interactions. These results suggest high acceptability of injectable PrEP among PWID. Future research could explore the advantages identified by female participants as well as implementation strategies for access and uptake among this vulnerable population.