2076. Increased awareness but persistently restricted access to pre-exposure prophylaxis against HIV (PrEP) in an urban midwestern community

Abstract Background Pre-exposure HIV prophylaxis (PrEP) was approved by the United States Food and Drug Administration in 2012, but uptake of PrEP by individuals in the community has been slow, especially among populations at high risk for HIV. Our study aims to assess changes in PrEP awareness and access between 2015 and 2020, during which a major community-wide PrEP awareness campaign was initiated in our community. Methods We surveyed patients at three sexually transmitted infection clinics in Cleveland, Ohio in 2015 and 2020. The participants’ involvement was voluntary and anonymous. Participants were asked questions regarding demographics, sexual behavior, and awareness and access to PrEP. Results Of the 910 and 262 patients surveyed in 2015 and 2020, 31.4% and 20.9% were ≥ 24 years old, 54.2% and 83.2% were Black, and 11.3% and 7.6% were men who have sex with men (MSM), respectively. PrEP awareness increased from 2015 to 2020 (18.0% vs. 57.7%, p< 0.001) while knowledge on how to access PrEP improved but remained low (18.1% vs. 32.0%, p< 0.001). PrEP awareness among Black MSM increased from 41.9% to 72.7% (p=0.02) and in 2020, there was no significant difference in PrEP awareness between Black and non-Black MSM (72.7% vs. 88.9%, p=0.56). Knowledge of access to PrEP was similar among Black and non-Black MSM (44.4% vs. 54.6%). Among Black women who have sex with men (WSM), PrEP awareness increased from 12.9% to 62.0% (p< 0.001) and knowledge of access to PrEP increased from 19.0% to 38.2% (p = 0.001). However, there remained a non-significant difference in knowledge of PrEP access between Black and non-Black WSM in 2020 (38.2% vs. 62.5%, p=0.07). Logistic regression adjusted for year, age, and MSM population showed Blacks were still less likely to be aware of PrEP compared with non-Blacks (OR 0.69, 95% CI 0.49, 0.98). Differences in PrEP awareness and access between Black and non-Black men who have sex with men (MSM) in 2015 and 2020. * p< 0.05 Difference in PrEP awareness and access between Black and non-Black women who have sex with men (WSM) in 2015 and 2020. Conclusion We observed an increase in PrEP awareness and knowledge of how to access PrEP between 2015 and 2020, especially among the Black population. However, when adjusted for year, age, and sexual preference, Blacks were still less likely to be aware of PrEP compared with non-Blacks. Knowledge on how to access PrEP remains low in the community regardless of race. With increased awareness of PrEP, novel approaches to increase knowledge of PrEP access are needed to address health disparities in our community. Disclosures All Authors: No reported disclosures.