Date of Completion


Embargo Period



Michael Copenhaver, Tania B. Huedo-Medina, Tricia Leahey

Field of Study

Health Promotion


Master of Science

Open Access

Open Access



Although people who use drugs (PWUD) are a key population recommended to receive pre-exposure prophylaxis (PrEP) to prevent HIV, few data are available to guide PrEP delivery in this underserved group. We therefore examined the willingness to initiate PrEP, the anticipation of HIV risk reduction while on PrEP, and the acceptability of PrEP based on a number of known PrEP attributes among high-risk PWUD.


In a cross-sectional study of 400 HIV-negative, opioid dependent individuals enrolled in a methadone program and reporting recent risk behaviors, we examined independent correlates of being willing to initiate PrEP. Participants also ranked the eight hypothetical PrEP program scenarios with varied combinations of six attributes related to PrEP (cost, dosing, efficacy, side-effects, treatment setting, and frequency of HIV testing).


While only 72 (18%) were aware of PrEP, after being given a description of it, 251 (62.7%) were willing to initiate PrEP. Willingness to initiate PrEP was associated with having neurocognitive impairment (aOR=3.184, p=0.004) and higher perceived HIV risk (aOR=8.044, p


Our findings showed high acceptability of PrEP in response to different PrEP program scenarios with different attribute profiles. While willingness to initiate PrEP was high and correlated with being at elevated risk for HIV and having NCI, anticipated higher risk behaviors in this group even while on PrEP suggests that the next generation of HIV prevention approaches may need to combine biomedical and behavioral components to improve adherence to PrEP and to sustain HIV risk reduction over time.

Major Advisor

Michael Copenhaver

Available for download on Thursday, November 22, 2018