Evidence map›Paper›PMID 38659491›Full record

ArticleLancet regional health. Americas2024

Equity of PrEP uptake by race, ethnicity, sex and region in the United States in the first decade of PrEP: a population-based analysis.

Patrick S Sullivan, Stephanie N DuBose, Amanda D Castel, Karen W Hoover, Marta Juhasz, Jodie L Guest, Gordon Le, Shamaya Whitby, Aaron J Siegler

Abstract read
In one paragraph

Article in Lancet regional health. Americas, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 97 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
97citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

97 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Utilizing Machine Learning for Predicting PrEP Use Status Among Sexual and Gender Minority Young Adults.Prevention science : the official journal of the Society for Prevention Research · 2026
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37 more citing papers are in PubMed but not listed here.

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

9 authors.

Patrick S SullivanRollins School of Public Health, Emory University, Atlanta, GA, USA.
Stephanie N DuBoseRollins School of Public Health, Emory University, Atlanta, GA, USA.
Amanda D CastelThe George Washington University Milken Institute School of Public Health, Washington, DC, USA.
Karen W HooverCenters for Disease Control and Prevention, Atlanta, GA, USA.
Marta JuhaszSaluda Analytics, Budapest, Hungary.
Jodie L GuestRollins School of Public Health, Emory University, Atlanta, GA, USA.
Gordon LeRollins School of Public Health, Emory University, Atlanta, GA, USA.
Shamaya WhitbyRollins School of Public Health, Emory University, Atlanta, GA, USA.
Aaron J SieglerRollins School of Public Health, Emory University, Atlanta, GA, USA.

Funding

Establishing PREMISE: A PrEP Epidemiology, Modeling, and Surveillance SystemR01AI181799 · NIAID · EMORY UNIVERSITY · PI Aaron Julius Siegler, Patrick Sean Sullivan · 2024 to 2026
$3.0M
NIAID NIH HHS R01 AI181799
6 · The paper itself

Abstract

Background: PrEP was approved for HIV prevention in the US in 2012; uptake has been slow. We describe relative equity with the PrEP Equity Ratio (PER), a ratio of PrEP-to-Need Ratios (PnRs). Methods: We used commercial pharmacy data to enumerate PrEP users by race and ethnicity, sex, and US Census region from 2012 to 2021. We report annual race and ethnicity-, sex-, and region-specific rates of PrEP use and PnR, a metric of PrEP equity, to assess trends. Findings: PrEP use increased for Black, Hispanic and White Americans from 2012 to 2021. By 2021, the rate of PrEP use per population was similar in Black and White populations but slightly lower among Hispanic populations. PnR increased from 2012 to 2021 for all races and ethnicities and regions; levels of PrEP use were inconsistent across regions and highly inequitable by race, ethnicity, and sex. In all regions, PnR was highest for White and lowest for Black people. Inequity in PrEP use by race and ethnicity, as measured by the PER, grew early after availability of PrEP and persisted at a level substantially below equitable PrEP use. Interpretation: From 2012 to 2021, PrEP use increased among Americans, but PrEP equity for Black and Hispanic Americans decreased. The US South lagged all regions in equitable PrEP use. Improved equity in PrEP use will be not only just, but also impactful on the US HIV epidemic; persons most at-risk of acquiring HIV should have the highest levels of access to PrEP. Prevention programs should be guided by PrEP equity, not PrEP equality. Funding: National Institutes of Health, Gilead Sciences.

Indexed as

Health equityPrEPPrEP to need ratioRegionSexUS South

Identifiers

PMID38659491
PMCPMC11041841

What OpenQuestion holds

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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.