Psychosocial Factors Related to Willingness to Use Pre-exposure Prophylaxis for HIV Prevention Among Black Men Who Have Sex with Men Attending a Community Event

Overview

Journal Sex Health

Specialty Infectious Diseases

Date 2014 Jul 9

PMID 25001553

Citations 67

Authors

Lisa A Eaton

Daniel D Driffin

Harlan Smith

Christopher Conway-Washington

Denise White

Chauncey Cherry

Affiliations

Soon will be listed here.

Abstract

Unlabelled: Objectives In the US, Black men who have sex with men (BMSM) are disproportionately affected by HIV/AIDS. Pre-exposure prophylaxis (PrEP) holds tremendous promise for curbing the HIV/AIDS epidemic among these men. However, many psychosocial components must be addressed in order to implement this prevention tool effectively among BMSM.

Methods: We assessed PrEP knowledge and use, health care access experiences, race-based medical mistrust, sexual partners and behaviours, and drug and alcohol use among 699 men attending a community event in the south-eastern United States. We used generalised linear modelling to assess factors associated with their willingness to use PrEP.

Results: Three hundred and ninety-eight men reported being BMSM and having HIV-negative status. Among these men, 60% reported being willing to use PrEP. Lack of being comfortable with talking to a health care provider about having sex with men, not having discussed having sex with a man with a health care provider, race-based medical mistrust, and alcohol consumption and substance use were all identified as barriers to willingness to use PrEP. Sexual risk-taking, number of sex partners and STI diagnosis were not associated with willingness to use PrEP.

Conclusions: Findings from the current paper demonstrate the importance of acknowledging the role of various psychosocial factors in the uptake of PrEP. It is imperative that we prioritise research into understanding these barriers better, as the failure to do so will impede the tremendous potential of this prevention technology.

Citing Articles

Perspectives and experiences regarding pre-exposure prophylaxis (PrEP) in a community sample of Veterans with unhealthy alcohol use: overall and across sexual orientation and gender identity.

Fletcher O, Beaver K, Austin E, Van Draanen J, Edelman E, Williams E Addict Sci Clin Pract. 2025; 20(1):5.

PMID: 39876005 PMC: 11773927. DOI: 10.1186/s13722-024-00533-y.

Assessing Structural Racism and Discrimination Along the Pre-exposure Prophylaxis Continuum: A Systematic Review.

Seyedroudbari S, Ghadimi F, Grady G, Uzosike O, Nkwihoreze H, Jemmott 3rd J AIDS Behav. 2024; 28(9):3001-3037.

PMID: 38851649 PMC: 11390845. DOI: 10.1007/s10461-024-04387-y.

Sociocultural and structural influences on HIV Pre-Exposure Prophylaxis (PrEP) Engagement and Uptake among African American Young adults.

Ayangeakaa S, Kerr J, Combs R, Harris L, Sears J, Parker K BMC Public Health. 2023; 23(1):1427.

PMID: 37495954 PMC: 10369814. DOI: 10.1186/s12889-023-16273-8.

Exploring the Association Between Gender Affirmation and PrEP use Among Transgender Women in New York City.

Rivera A, Lopez J, Braunstein S AIDS Behav. 2022; 27(5):1523-1530.

PMID: 36574185 PMC: 10191875. DOI: 10.1007/s10461-022-03944-7.

Preferences Among Physicians and Men Who Have Sex with Men (MSM) for a Long-Acting, Removable Implant for HIV Prevention: A Discrete Choice Study.

Rael C, Giguere R, Sutton S, Horn E, Schieffer R, Greene G AIDS Res Hum Retroviruses. 2022; 38(12):898-908.

PMID: 36178358 PMC: 9805877. DOI: 10.1089/AID.2022.0035.

References

Shelton R, Winkel G, Davis S, Roberts N, Valdimarsdottir H, Hall S . Validation of the group-based medical mistrust scale among urban black men. J Gen Intern Med. 2010; 25(6):549-55. PMC: 2869405. DOI: 10.1007/s11606-010-1288-y. View

Christopoulos K, Das M, Colfax G . Linkage and retention in HIV care among men who have sex with men in the United States. Clin Infect Dis. 2011; 52 Suppl 2:S214-22. PMC: 3106256. DOI: 10.1093/cid/ciq045. View

Grant R, Lama J, Anderson P, McMahan V, Liu A, Vargas L . Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010; 363(27):2587-99. PMC: 3079639. DOI: 10.1056/NEJMoa1011205. View

Halkitis P, Zade D, Shrem M, Marmor M . Beliefs about HIV non-infection and risky sexual behavior among MSM. AIDS Educ Prev. 2004; 16(5):448-58. DOI: 10.1521/aeap.16.5.448.48739. View

Thompson H, Valdimarsdottir H, Winkel G, Jandorf L, Redd W . The Group-Based Medical Mistrust Scale: psychometric properties and association with breast cancer screening. Prev Med. 2004; 38(2):209-18. DOI: 10.1016/j.ypmed.2003.09.041. View

Golub S, Gamarel K, Rendina H, Surace A, Lelutiu-Weinberger C . From efficacy to effectiveness: facilitators and barriers to PrEP acceptability and motivations for adherence among MSM and transgender women in New York City. AIDS Patient Care STDS. 2013; 27(4):248-54. PMC: 3624632. DOI: 10.1089/apc.2012.0419. View

Mayer K . Introduction: Linkage, engagement, and retention in HIV care: essential for optimal individual- and community-level outcomes in the era of highly active antiretroviral therapy. Clin Infect Dis. 2011; 52 Suppl 2:S205-7. DOI: 10.1093/cid/ciq043. View

McFarland W, Chen Y, Nguyen B, Grasso M, Levine D, Stall R . Behavior, intention or chance? A longitudinal study of HIV seroadaptive behaviors, abstinence and condom use. AIDS Behav. 2011; 16(1):121-31. PMC: 3686637. DOI: 10.1007/s10461-011-9936-8. View

Eaton L, West T, Kenny D, Kalichman S . HIV transmission risk among HIV seroconcordant and serodiscordant couples: dyadic processes of partner selection. AIDS Behav. 2008; 13(2):185-95. PMC: 2937197. DOI: 10.1007/s10461-008-9480-3. View

10.

Mugavero M, Amico K, Horn T, Thompson M . The state of engagement in HIV care in the United States: from cascade to continuum to control. Clin Infect Dis. 2013; 57(8):1164-71. DOI: 10.1093/cid/cit420. View

11.

Gamble V . Under the shadow of Tuskegee: African Americans and health care. Am J Public Health. 1997; 87(11):1773-8. PMC: 1381160. DOI: 10.2105/ajph.87.11.1773. View

12.

Hammond W . Psychosocial correlates of medical mistrust among African American men. Am J Community Psychol. 2010; 45(1-2):87-106. PMC: 2910212. DOI: 10.1007/s10464-009-9280-6. View

13.

Ulett K, Willig J, Lin H, Routman J, Abroms S, Allison J . The therapeutic implications of timely linkage and early retention in HIV care. AIDS Patient Care STDS. 2008; 23(1):41-9. PMC: 2733237. DOI: 10.1089/apc.2008.0132. View

14.

Saunders J, Aasland O, Babor T, De la Fuente J, Grant M . Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II. Addiction. 1993; 88(6):791-804. DOI: 10.1111/j.1360-0443.1993.tb02093.x. View

15.

Eaton L, Kalichman S, Cherry C . Sexual partner selection and HIV risk reduction among Black and White men who have sex with men. Am J Public Health. 2010; 100(3):503-9. PMC: 2820059. DOI: 10.2105/AJPH.2008.155903. View

16.

Liu A, Kittredge P, Vittinghoff E, Raymond H, Ahrens K, Matheson T . Limited knowledge and use of HIV post- and pre-exposure prophylaxis among gay and bisexual men. J Acquir Immune Defic Syndr. 2008; 47(2):241-7. View

17.

LaVeist T, Nickerson K, Bowie J . Attitudes about racism, medical mistrust, and satisfaction with care among African American and white cardiac patients. Med Care Res Rev. 2000; 57 Suppl 1:146-61. DOI: 10.1177/1077558700057001S07. View

18.

Mimiaga M, Case P, Johnson C, Safren S, Mayer K . Preexposure antiretroviral prophylaxis attitudes in high-risk Boston area men who report having sex with men: limited knowledge and experience but potential for increased utilization after education. J Acquir Immune Defic Syndr. 2009; 50(1):77-83. PMC: 2659469. DOI: 10.1097/QAI.0b013e31818d5a27. View

19.

Sullivan P, Hamouda O, Delpech V, Geduld J, Prejean J, Semaille C . Reemergence of the HIV epidemic among men who have sex with men in North America, Western Europe, and Australia, 1996-2005. Ann Epidemiol. 2009; 19(6):423-31. DOI: 10.1016/j.annepidem.2009.03.004. View

20.

Bynum S, Davis J, Green B, Katz R . Unwillingness to participate in colorectal cancer screening: examining fears, attitudes, and medical mistrust in an ethnically diverse sample of adults 50 years and older. Am J Health Promot. 2012; 26(5):295-300. PMC: 3807238. DOI: 10.4278/ajhp.110113-QUAN-20. View