Results indicate that in this sample, awareness of the newer biomedical interventions to prevent HIV transmission was low. At study entry, most preferred male condoms as a prevention method, though condom use was low or suboptimal. However, following a brief intervention, participants’ preferences would include other prevention methods. The low awareness regarding PrEP in this NSC 683864 study is similar to that reported in other settings;10–13

however, we are not aware of any other reports from the USA that also evaluated knowledge and preferences for male circumcision and microbicides. A recent report of serodiscordant couples in South Carolina found high levels of acceptability of PrEP if available; but participants’ awareness of PrEP prior to the study was not assessed.13 Results from the present study suggest that the relative acceptance of a prevention method can

be affected by the availability of other more appealing methods. Results may also suggest that the ability to fully understand some of these methods may vary by the type of method and that the concept of PrEP in particular may be more difficult to comprehend than the others. Interestingly, the current study also showed that the interest in a vaccine is high, though neither the pamphlet nor video included any information on vaccines. These findings would suggest that the concept of “vaccines” is much more familiar (and acceptable) to patients as a preventive strategy than these

other novel methods. This study highlights the need to provide more information about newer methods of HIV prevention to at-risk patients. It also demonstrates the need for assessment of patient knowledge and preferences for these methods, to better design a triage system to optimize the delivery of these prevention strategies. Strengths The sample of participants was drawn from a multiracial and multiethnic STD clinic that should be one of the primary targets to implement HIV prevention interventions, given the high incidence of HIV in the city and in the clinic. Limitations During the conduct of this study, there was an ongoing demonstration project in the clinic to provide PrEP to men AV-951 who have sex with men. This exposure may have biased participant knowledge and preference for this method of HIV prevention. A randomized control group was not used, and as a result, it was not possible to be certain that the intervention caused the outcome. The reason why this study did not include a control arm was that this study was funded as a pilot. However, this study has generated the need to plan for a larger study that will include a control arm. The sample size of this pilot study prevented subanalyses by ethnicity or sexual preference; future research should be conducted with larger samples and control groups to address these issues.