ArticleAnnals of epidemiology2018
The prevalence of pre-exposure prophylaxis use and the pre-exposure prophylaxis-to-need ratio in the fourth quarter of 2017, United States.
Article in Annals of epidemiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 270 papers, 3 of them syntheses that pooled it.
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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.
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Who cites it
270 citing papers in PubMed, 3 syntheses or guidelines pooled it, 422 citations in OpenAlex.
- Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV - CDC Recommendations, United States, 2025.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2025Guideline
- A Systematic Review and Narrative Synthesis of Factors Affecting Pre-exposure Prophylaxis Willingness Among Black Women for HIV Prevention.AIDS and behavior · 2025Pooled it
- A Systematic Review of Implementation Research on Determinants and Strategies of Effective HIV Interventions for Men Who Have Sex with Men in the United States.Annual review of psychology · 2024Pooled it
- Oral Preexposure Prophylaxis Uptake and Discontinuation in the HIV Vaccine Trials Network 704/HIV Prevention Trials Network 085 Study: Implications for Biomedical Human Immunodeficiency Virus Prevention Trials.Open forum infectious diseases · 2024Trial
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- Associations Between Psychosocial Factors and Pre-exposure Prophylaxis (PrEP) Adherence Among Black Men Who Have Sex with Men in Ending the HIV Epidemic Jurisdictions: Findings from Project Adhere.Archives of sexual behavior · 2026Article
- Characteristics of US Counties with Low Pre-exposure Prophylaxis (PrEP) Use and Limited Access to PrEP Prescribing Clinics.AIDS and behavior · 2026Article
- A Decade of Improvement and Signs of Decline in PrEP Awareness and Use in Young Trans Women.AIDS and behavior · 2026Article
- Long-Acting Injectable Cabotegravir Use and Persistence Over 2 Years.JAMA network open · 2026Article
- Beliefs About Toxic Interactions Between Alcohol and PrEP Predict Less Initiation and More Discontinuation: Results from the RADAR Cohort Study.AIDS and behavior · 2026Article
- Facilitators and Barriers to Equitable Implementation of Telehealth PrEP Delivery: A Qualitative Descriptive Study of Program Staff and Stakeholders.Health promotion practice · 2026Article
- HIV/STI Prevention Strategies During COVID-19 Among PrEP-Eligible Cisgender Women in New York State: A Qualitative Analysis.International journal of environmental research and public health · 2026Article
- PrEP Prescriptions at 2 Federally Qualified Health Centers.Sexually transmitted diseases · 2026Article
- A culturally relevant sexual health campaign for Latino gay and bisexual men in a Southern U.S. Metropolitan area.Journal of communication in healthcare · 2026Article
- Trends in Persons Prescribed HIV Postexposure Prophylaxis in the United States, 2015-2023.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Article
- The 2025 Centers for Disease Control and Prevention Nonoccupational HIV Postexposure Prophylaxis Guidelines: Updated Regimens and Remaining Questions.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Considerations of HIV PrEP Among Heterosexually Active Women and Men: Results from a Qualitative Study in New York City.Archives of sexual behavior · 2026Article
- Assessing Non-Oral PrEP Alternatives Among Young Black Women in the Southern USA.Journal of racial and ethnic health disparities · 2026Article
210 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
Abstract
purposeThe number of individuals who have started a regimen for HIV pre-exposure prophylaxis (PrEP) in the United States is not well characterized but has been on the rise since 2012. This analysis assesses the distribution of PrEP use nationally and among subgroups.
methodsA validated algorithm quantifying tenofovir disoproxil fumarate/emtricitabine for PrEP in the United States was applied to a national prescription database to determine the quarterly prevalence of PrEP use. HIV diagnoses from 2016 were used as an epidemiological proxy for PrEP need. The PrEP-to-need ratio (PnR) was defined as the number of PrEP users divided by new HIV diagnoses.
resultsA total of 70,395 individuals used PrEP in the fourth quarter of 2017: 67,166 males and 3229 females. Nationally, prevalence of PrEP use was 26/100,000 (range across states per 100,000 [RAS/100k]: 4-73) and the PnR was 1.8 (RAS: 0.5-6.6). Prevalence of PrEP use among males and females, respectively, was 50/100,000 and 2/100,000 (RAS/100k: 7-143 and 0.3-7) and PnR was 2.1 and 0.4 (RAS: 0.6-7.1 and 0.1-4.0). Prevalence of PrEP use was lowest among individuals aged less than or equal to 24 and more than or equal to 55 years (15/100,000 and 6/100,000, RAS/100k: 1-45 and 0.4-14), with PnR 0.9 and 1.5 (RAS: 0.2-5.6 and 0.3-7.0). The Northeast had the highest PnR (3.3); the South had the lowest (1.0). States with Medicaid expansion had more than double the PnR than states without expansion.
conclusionsAvailable data suggest that females, individuals aged less than or equal to 24 years and residents of the South had lower levels of PrEP use relative to epidemic need. These results are ecological, and misclassification may attenuate results. PnR is useful for future assessments of HIV prevention strategy uptake.
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