Abstract
BACKGROUND: Preexposure prophylaxis (PrEP) is a medication that prevents HIV infection. However, PrEP is not equally used by all who would benefit. We examined PrEP disparities by comparing the number of sexually transmitted infections (STIs) and PrEP prescriptions across sex, race, and ethnic groups from 2 federally qualified health centers (FQHCs) in Pinellas County, Florida, and Chicago, Illinois. METHODS: We obtained limited electronic medical record data from January 1, 2023, to December 31, 2023, and identified STI diagnoses (gonorrhea, chlamydia, or syphilis) and PrEP initiation prescriptions. We calculated the PrEP initiation rate for different sex, race, and ethnicity groups; the rate difference in PrEP initiations for each demographic group compared with that in White men; and the ratio of PrEP initiations to STI diagnoses in each group. RESULTS: Out of a total of 63,591 patients, 1208 (1.9%) were diagnosed with an STI and 88 (0.1%) had PrEP initiation prescriptions. There was no rate difference per 100 people in PrEP initiation among Black and White men, but Hispanic men (-0.11), Black women (-0.14), White women (-0.24), and Hispanic women (-0.25) demonstrated PrEP disparities. When examining the ratio of PrEP initiations to STI diagnoses in each group, White men had (0.42) PrEP initiations per STI diagnosis, with much lower ratios seen for Hispanic men (0.2), Black men (0.13), Black women (0.04), White women (0.03), and Hispanic women (0.02). CONCLUSIONS: White men had the highest rate of initial PrEP prescriptions. Men overall received PrEP between 3 and 21 times more frequently per STI diagnosis than women.