A New Look at Socioeconomic Determinants of Pre-exposure Prophylaxis (PrEP) Usage in Rural and Urban Counties

Abstract

One recent innovation in the fight against the HIV epidemic is that of pre-exposure prophylaxis (PrEP), a combination of tenofovir and emtricitabine that has been shown to reduce the risk of contracting HIV by 99% when taken daily. However, PrEP access is hindered across the United States due to numerous disparities. For example, looking at geography alone, only 12% of PrEP access sites nationwide are found in rural areas, compared to 88% in urban areas. Therefore, this study looks to address the rural-urban disparity by examining the socioeconomic determinants of PrEP usage in select rural areas in comparison to those in urban areas, providing crucial information for the expansion of PrEP access in rural communities. This was done through the collection of various socioeconomic data and PrEP prevalence data for rural and urban counties in Ohio, Illinois, and Indiana, using databases from the American Community Survey and AidsVu. PrEP prevalence data was then correlated with various socioeconomic variables through the formation of separate linear regressions for urban and rural communities. Comparisons between these models suggest that PrEP usage is concentrated among younger populations in urban communities, as opposed to older populations within rural communities. In addition, the effects of education and racial composition seem to be pronounced in urban areas, while they do not significantly affect PrEP prevalence in rural areas. Such information may prove vital in the development of interventions designed to target populations within rural counties, increasing PrEP access and addressing PrEP disparities across the US.