PrEP awareness and barriers to uptake: insights from college campuses across South Carolina.

Objective: To assess PrEP awareness, HIV risk perception, uptake, and factors influencing pre-exposure prophylaxis (PrEP) use among college students in South Carolina. Participants: A total of 174 students attending sexual health and HIV testing events at 20 college campuses, including all eight HBCUs in South Carolina. Methods: A 17-item electronic survey was administered (September-October 2024). Descriptive analyses examined demographics, PrEP awareness, HIV risk, preferences, and use. Results: Half of the respondents had heard of PrEP, and 2% reported current use. Most considered themselves at no or low HIV risk, including 80% of those with a recent sexually transmitted infection (STI) and 85.6% with inconsistent condom use. Barriers included low perceived risk, lack of knowledge, and cost concerns. Nonheterosexual men had higher PrEP awareness and risk perception but low uptake. Conclusions: Findings highlight the need for focused education, improved risk perception, and expanded PrEP access through trusted providers, including college health centers and primary care clinics.