Intent to Use Preexposure Prophylaxis (PrEP), HIV Risk Behaviors, and Self-Report Neurocognitive Symptoms by High-Risk Drug Users: A Mediation Analysis.

Participants were recruited by convenience sampling from one methadone clinic, so the findings may not apply to other people who use drugs or other settings. All measures were self-reported, including neurocognitive symptoms and HIV risk behavior, so sensitive or socially undesirable behaviors may have been under-reported. The Brief Inventory of Neurocognitive Impairment was not a comprehensive cognitive assessment and could not measure all cognitive domains. The data were cross-sectional, so the study can show associations but cannot show that neurocognitive symptoms cause HIV risk behavior or PrEP intent. Intent to use PrEP was measured after a brief description, and the study did not assess how well participants understood PrEP. The parent study sample size was based on an outcome unrelated to this mediation analysis.

The authors reported no real or perceived vested interests that could be construed as a conflict of interest.

Do not read this as evidence that PrEP education increases uptake or that neurocognitive symptoms cause PrEP intent. The study measured self-reported associations and interest after a brief description, not actual PrEP use, adherence, or causal effects.