Evidence map›Paper›PMID 25386746›Full record

ArticlePloS one2014

Access to healthcare, HIV/STI testing, and preferred pre-exposure prophylaxis providers among men who have sex with men and men who engage in street-based sex work in the US.

Kristen Underhill, Kathleen M Morrow, Christopher M Colleran, Richard Holcomb, Don Operario, Sarah K Calabrese, Omar Galárraga, Kenneth H Mayer

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed
10.4field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

45 citing papers in PubMed, 72 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 1 country.

Kristen UnderhillYale Center for Interdisciplinary Research on AIDS/Yale Law School, Yale University, New Haven, Connecticut, United States of America.
Kathleen M MorrowCenters for Behavioral & Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, United States of America.
Christopher M ColleranCenters for Behavioral & Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, United States of America.
Richard HolcombProject Weber, Providence, Rhode Island, United States of America.
Don OperarioSchool of Public Health, Brown University, Providence, Rhode Island, United States of America.
Sarah K CalabreseYale School of Public Health, Yale University, New Haven, Connecticut, United States of America.
Omar GalárragaSchool of Public Health, Brown University, Providence, Rhode Island, United States of America.
Kenneth H MayerThe Fenway Institute, Fenway Health, Boston, Massachusetts, United States of America.
Brown University · USMiriam Hospital · USYale University · USFenway Health · USProvidence College · US

Funding

Using Coincidence Analysis to Investigate Factors Affecting PrEP Initiation and Continuation in Southern ending the Epidemic CountiesP30MH062294 · NIMH · YALE UNIVERSITY · PI John Edward Pachankis · 2001 to 2026
$48.5M
INTERDISCIPLINARY HIV PREVENTION TRAINING PROGRAMT32MH020031 · NIMH · YALE UNIVERSITY · PI Trace S Kershaw · 1999 to 2026
$12.1M
Minority Populations Prevention Researcher TrainingR25HD045810 · NICHD · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI NEILANDS, TORSTEN BRIAN · 2003 to 2018
$4.3M
PrEP for HIV Prevention in MSM: Mixed-Methods Study of Behavior & Message FramingK01MH093273 · NIMH · YALE UNIVERSITY · PI UNDERHILL, KRISTEN · 2011 to 2015
$873k
Advancing Reproductive Health: Qualitative Methods & Interdisciplinary MentorshipK24HD062645 · NICHD · MIRIAM HOSPITAL · PI GUTHRIE, KATE M · 2012 to 2016
$689k
Intervention to Promote PrEP Awareness and Equitable Prescription among ProvidersK01MH103080 · NIMH · YALE UNIVERSITY · PI CALABRESE, SARAH K. · 2014 to 2017
$634k
NICHD NIH HHS K24 HD062645NICHD NIH HHS R25 HD045810NIMHD NIH HHS L60 MD008519NIMH NIH HHS 5K01MH093273NIMH NIH HHS K01 MH093273NIMH NIH HHS K01 MH103080NIMH NIH HHS P30 MH062294NIMH NIH HHS T32 MH020031
6 · The paper itself

Abstract

backgroundPre-exposure prophylaxis (PrEP) is a promising strategy for HIV prevention among men who have sex with men (MSM) and men who engage in sex work. But access will require routine HIV testing and contacts with healthcare providers. This study investigated men's healthcare and HIV testing experiences to inform PrEP implementation.

methodsWe conducted 8 focus groups (n = 38) in 2012 and 56 in-depth qualitative interviews in 2013-14 with male sex workers (MSWs) (n = 31) and other MSM (n = 25) in Providence, RI. MSWs primarily met clients in street-based sex work venues. Facilitators asked participants about access to healthcare and HIV/STI testing, healthcare needs, and preferred PrEP providers.

resultsMSWs primarily accessed care in emergency rooms (ERs), substance use clinics, correctional institutions, and walk-in clinics. Rates of HIV testing were high, but MSWs reported low access to other STI testing, low insurance coverage, and unmet healthcare needs including primary care, substance use treatment, and mental health services. MSM not engaging in sex work were more likely to report access to primary and specialist care. Rates of HIV testing among these MSM were slightly lower, but they reported more STI testing, more insurance coverage, and fewer unmet needs. Preferred PrEP providers for both groups included primary care physicians, infectious disease specialists, and psychiatrists. MSWs were also willing to access PrEP in substance use treatment and ER settings.

conclusionsPrEP outreach efforts for MSWs and other MSM should engage diverse providers in many settings, including mental health and substance use treatment, ERs, needle exchanges, correctional institutions, and HIV testing centers. Access to PrEP will require financial assistance, but can build on existing healthcare contacts for both populations.

Indexed as

Health Services AccessibilityPre-Exposure ProphylaxisSex WorkersAdultAmbulatory Care FacilitiesDelivery of Health CareHealth Care CostsHIV InfectionsHomosexuality, MaleHumansInsurance CoverageMaleMenMental Health ServicesPatient Acceptance of Health CareRhode Island

Identifiers

PMID25386746
PMCPMC4227700
OpenAlexW1980105255

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.