scholarly journals Pre-Exposure Prophylaxis (PrEP) Uptake among Black Men Who Have Sex with Men (BMSM) in the Southern U.S.

2021 ◽  
Vol 18 (18) ◽  
pp. 9715
Author(s):  
Oluwafemi Adeagbo ◽  
Sayward Harrison ◽  
Shan Qiao ◽  
Xiaoming Li
Keyword(s):  
Hiv Prevention ◽  
Black Men ◽  
Healthcare Providers ◽  
Rapid Expansion ◽  
Hiv Care ◽  
Hiv Incidence ◽  
Interdisciplinary Approaches ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
The U.S

Black men who have sex with men (BMSM) living in the United States (U.S.) South are disproportionately affected by HIV and experience significant disparities in HIV incidence, access to HIV care, and prevention across ages and socio-economic statuses. The aim of this commentary is to critically review current literature on the state of PrEP use among BMSM in the U.S. South, including identifying barriers and facilitators to PrEP use in order to inform intervention development. Extant literature shows that despite the documented benefits of PrEP as an effective HIV-prevention method, its uptake among BMSM is limited across the U.S. South. Common barriers to PrEP uptake included stigma, homophobia, mistrust of healthcare systems, negative attitudes from healthcare providers, access and transportation issues, poverty, and misinformation about PrEP. These barriers are likely to have been further exacerbated by the COVID-19 pandemic. Limited access to PrEP and other HIV-prevention programs, such as HIV testing, post-exposure prophylaxis (PEP), and condoms for BMSM are likely increase HIV incidence in this community. Moreover, the rapid expansion of telehealth services during the COVID-19 period may offer increased opportunity to scale-up PrEP through telehealth interventions, especially if in-person services remain limited due to pandemic precautions. Given the intersectional barriers that limit the access and uptake of PrEP among BMSM, we suggest that tailored programs or interventions that seek to address PrEP disparities among Southern BMSM should adopt intersectional and interdisciplinary approaches to better understand the complex challenges of scaling up PrEP. More studies are needed to investigate the impact of COVID-19 on HIV-prevention services among BMSM and to understand how to co-develop—with the BMSM community and healthcare providers—culturally acceptable interventions to reduce the identified challenges using intersectional and interdisciplinary approaches.

scholarly journals Disseminated Effects in Agent Based Models: A Potential Outcomes Framework and Application to Inform Pre-Exposure Prophylaxis Coverage Levels for HIV Prevention

2020 ◽  
Author(s):  
Ashley L Buchanan ◽  
S Bessey ◽  
William C Goedel ◽  
Maximilian King ◽  
Eleanor J Murray ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Hiv Incidence ◽  
Agent Based Models ◽  
Coverage Level ◽  
Sexual Network ◽  
Agent Based ◽  
Sex With Men ◽  
The Individual ◽  
Exposure Prophylaxis ◽  
Potential Outcomes Framework

Abstract Pre-exposure prophylaxis (PrEP) for HIV prevention may not only benefit the individual who uses it, but also their uninfected sexual risk contacts. We developed an agent-based model using a novel trial emulation approach to quantify disseminated effects of PrEP use among men who have sex with men in Atlanta, USA from 2015 to 2017. Components (subsets of agents connected through partnerships in a sexual network, but not sharing partnerships with any other agents) were first randomized to an intervention coverage level or control, then within intervention components, eligible agents were randomized to PrEP. We estimated direct and disseminated (indirect) effects using randomization-based estimators and reported corresponding 95% simulation intervals across scenarios ranging from 10% to 90% coverage in the intervention components. A population of 11,245 agents was simulated with an average of 1,551 components identified. Comparing agents randomized to PrEP in 70% coverage components to control agents, there was a 15% disseminated risk reduction in HIV incidence (95% simulation intervals = 0.65, 1.05). Individuals not on PrEP may receive a protective benefit by being in a sexual network with higher PrEP coverage. Agent-based models are useful to evaluate possible direct and disseminated effects of HIV prevention modalities in sexual networks.

scholarly journals HIV Information Acquisition and Use among Young Black Men Who Have Sex with Men Who Use the Internet: A Mixed Methods Study (Preprint)

2020 ◽  
Author(s):  
Megan Threats ◽  
Keosha Bond
Keyword(s):  
Social Media ◽  
Hiv Prevention ◽  
Health Information ◽  
Black Men ◽  
Information Acquisition ◽  
Healthcare Providers ◽  
The Internet ◽  
Prevention And Treatment ◽  
Online Spaces ◽  
Sex With Men

BACKGROUND Background: Human immunodeficiency virus (HIV) disproportionately affects young black men who have sex with men (YBMSM) in the United States. Electronic health (eHealth) and mobile health (mHealth) hold significant potential for supporting engagement in HIV prevention and care, and the delivery of HIV information to YBMSM. OBJECTIVE To investigate technology utilization, internet access, and HIV information acquisition and use among YBMSM. METHODS An online survey and semi-structured interviews were conducted. Survey findings informed the development of the interview guide. Descriptive statistics were used to characterize the survey sample, and interview data was analyzed thematically using modified grounded theory methodologies. RESULTS Among the internet sample (N=83), the average age was 29.2 years, 41% of participants self-reported living with HIV, 43.4% were HIV-negative, and 15.6% were unsure of their HIV-status. Most participants (95%) acquired HIV information through the Internet while using a mobile phone. Online HIV information was intentionally sought from consumer health information websites (37.3%), government health information websites (30%), and social media sites (17%). Most men incidentally acquired HIV information via advertisements on social media sites and geospatial dating applications (65.39%), postings on social media sites from their online social ties (53.84%), and advertisements while browsing the Internet (48.72%). Despite the Internet being the top source of HIV information, healthcare providers were the most preferred (50.6%) and trusted (96%) source of HIV information. HIV information was used to facilitate the utilization of HIV prevention and treatment services. The qualitative sample included YBMSM across a range of ages and at different points of engagement in HIV prevention and treatment. Qualitative findings included the importance of the Internet as a primary source of HIV information. The Internet was used due to its ease of accessibility, the ability to maintain anonymity while searching for sensitive information, and to mitigate against stigma in healthcare settings. Participants used HIV information to assess their risk for HIV/AIDS, support their self-efficacy for HIV prevention and treatment, inform patient-doctor communication, and to learn about HIV prevention and treatment options. Men expressed concerns about their diminishing access to online spaces for HIV information exchange among YBMSM due to website censorship policies, and the “stigmatizing” tone of HIV information presented in mass media campaigns. CONCLUSIONS YBMSM in this sample had high utilization of the internet and mobile technologies for HIV information acquisition and use, but diminished access to their preferred and most trusted source of HIV information: healthcare providers. Future eHealth and mHealth HIV prevention and treatment interventions should support communication between patients and healthcare providers. Findings demonstrate the need for culturally appropriate HIV messaging, and online spaces for informational support exchange among YBMSM.

The PrEP Up Pharmacies Study: Protocol for integrating and disseminating pre-exposure prophylaxis (PrEP) screening and dispensing in community pharmacies for Black men who have sex with men in Atlanta, Georgia (Preprint)

2021 ◽  
Author(s):  
Natalie D. Crawford ◽  
Kristin R.V. Harrington ◽  
Daniel Alohan ◽  
Patrick S. Sullivan ◽  
David P. Holland ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Black Men ◽  
Racial Minority ◽  
High Poverty ◽  
Pilot Phase ◽  
Pharmacy Staff ◽  
Delivery Model ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Pilot Intervention

BACKGROUND Black men who have sex with men (BMSM) suffer from alarmingly high rates of HIV in the United States. Pre-exposure prophylaxis (PrEP) can reduce risk of HIV infection by 99% among MSM, yet profound racial disparities in the uptake of PrEP persist. Low PrEP uptake in BMSM is driven by poor access to PrEP including inconvenient locations of PrEP-prescribing physicians and distrust of physicians and stigma, which limit communication about PrEP and its side effects. Previous work indicates that offering HIV prevention services in pharmacies located in high poverty, racial minority neighborhoods is feasible and can reduce stigma because pharmacies offer a host of less stigmatized health services (e.g. vaccinations). We present a protocol for a pharmacy PrEP model that seeks to address challenges and barriers to pharmacy-based PrEP specifically for BMSM. OBJECTIVE To develop a sustainable pharmacy PrEP delivery model that can be implemented to increase PrEP access in high poverty, racial minority neighborhoods for BMSM. METHODS This study design is a pilot intervention to test a pharmacy PrEP delivery model among pharmacy staff and BMSM. We will examine the PrEP delivery model’s feasibility, acceptability and safety, and gather early evidence of its impact and cost with respect to PrEP uptake. A mixed methods approach will be performed including three study phases: 1) a completed formative phase with qualitative interviews from key stakeholders; 2) a completed transitional pilot phase to assess customer eligibility and willingness to receive PrEP in pharmacies during COVID-19; and 3) a planned pilot intervention phase which will test the delivery model in two Atlanta pharmacies in high poverty, racial minority neighborhoods. RESULTS Data from the formative phase showed strong support of pharmacy-based PrEP delivery among BMSM, pharmacists and pharmacy staff. Important factors were identified to facilitate implementation of PrEP screening and dissemination in pharmacies. During the transitional pilot phase, we identified 81 individuals who would have been eligible for the pilot phase. CONCLUSIONS Pharmacies have proven to be a feasible source for offering PrEP for White MSM, but have failed to reach the most at-risk, vulnerable population – BMSM. Increasing PrEP access and uptake will reduce HIV incidence and racial inequities in HIV. Translational studies are required to build further evidence and scale pharmacy-based PrEP services specifically for populations that are disconnected from HIV prevention resources.

scholarly journals Building effective multilevel HIV prevention partnerships with Black men who have sex with men: experience from HPTN 073, a pre-exposure prophylaxis study in three US cities

2018 ◽  
Vol 21 ◽  
pp. e25180 ◽  
Author(s):  
Darrell P Wheeler ◽  
Jonathan Lucas ◽  
Leo Wilton ◽  
LaRon E Nelson ◽  
Christopher Hucks-Ortiz ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Black Men ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Us Cities

scholarly journals A Multi-US City Assessment of Awareness and Uptake of Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Black Men and Transgender Women Who Have Sex with Men

2017 ◽  
Vol 18 (5) ◽  
pp. 505-516 ◽  
Author(s):  
Lisa A. Eaton ◽  
◽  
Derrick D. Matthews ◽  
Daniel D. Driffin ◽  
Leigh Bukowski ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Black Men ◽  
Transgender Women ◽  
Sex With Men ◽  
Exposure Prophylaxis

scholarly journals Small Randomized Controlled Trial of the New Passport to Wellness HIV Prevention Intervention for Black Men Who Have Sex With Men (BMSM)

2020 ◽  
Vol 32 (4) ◽  
pp. 311-324
Author(s):  
Nina T. Harawa ◽  
Katrina M. Schrode ◽  
Charles McWells ◽  
Robert E. Weiss ◽  
Charles L. Hilliard ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Black Men ◽  
Peer Support ◽  
Social Determinants ◽  
Controlled Trial ◽  
Post Exposure Prophylaxis ◽  
Sti Prevention ◽  
Hiv Prevention Intervention ◽  
Sex With Men ◽  
Exposure Prophylaxis

We developed and tested Passport to Wellness (PtW), a client-centered intervention to improve engagement in HIV/STI prevention and services to improve social determinants of health among Black men who have sex with men (BMSM) using incentives and peer support. We assessed PtW's impact on HIV/STI screening and pre/post-exposure prophylaxis (PrEP/PEP) knowledge/uptake using a randomized trial that compared the full intervention to one lacking peer support. We compared changes within groups surveyed at baseline and 6 months. We enrolled 80 eligible BMSM, among 399 screened. Among retained participants (34 peer-supported; 27 comparison), overall increases were observed in HIV (30% to 87% p < .001) and STI (28% to 80% p < .001) testing within the prior 6 months, as well as in PrEP and PEP awareness, and PrEP use. Statistically significant between group differences were not observed. Tailored prevention planning, incentives, and addressing social determinants may help move Black MSM along the HIV prevention continuum.

scholarly journals PrEP Chicago: A randomized controlled peer change agent intervention to promote the adoption of pre-exposure prophylaxis for HIV prevention among young Black men who have sex with men

2017 ◽  
Vol 15 (1) ◽  
pp. 44-52 ◽  
Author(s):  
Lindsay E Young ◽  
Phil Schumm ◽  
Leigh Alon ◽  
Alida Bouris ◽  
Matthew Ferreira ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Black Men ◽  
Change Agent ◽  
Randomized Controlled ◽  
Sex With Men ◽  
Exposure Prophylaxis

scholarly journals Facilitators and barriers of 2-1-1 HIV pre-exposure prophylaxis

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251917
Author(s):  
Christina Camp ◽  
Parya Saberi
Keyword(s):  
Hiv Prevention ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Facilitators And Barriers ◽  
Sexual Encounters ◽  
Prevention Method ◽  
Sex With Men ◽  
Dosing Strategy ◽  
Exposure Prophylaxis

An alternative strategy for men who have sex with men (MSM) experiencing challenges with daily HIV pre-exposure prophylaxis (PrEP) includes 2-1-1 dosing. Understanding 2-1-1 PrEP facilitators and barriers, especially during the SARS-CoV-2 pandemic, may guide researchers and healthcare providers in future studies and clinical preparedness. We conducted a national cross-sectional study of MSM in the US who had taken 2-1-1 PrEP to examine facilitators and barriers of this on-demand PrEP dosing option. With the shelter-in-place orders in March 2020, this study was adapted to include questions on how the SARS-CoV-2 pandemic affected participants’ PrEP use. A total of 140 individuals participated in the survey, 106 of which completed questions pertaining to the SARS-CoV-2 pandemic. The most common reasons for switching from once-daily to 2-1-1 PrEP included having sex less frequently (63.6%) and wanting to take fewer pills (46.4%). Participants reported high medication adherence based on each component of 2-1-1 PrEP dosing (>84%). The most common barriers with 2-1-1 PrEP dosing included unplanned sexual encounters resulting in missing the double-dose pre-sex (43.6%) and trouble remembering doses post-sex (29.3%). Facilitators of the 2-1-1 PrEP dosing strategy included reductions in sexual encounters (63.6%), preference to take fewer pills (46.4%), need to reduce cost (22.1%), and desire to reduce side effects (19.3%). Challenges to receiving PrEP services during the pandemic included obtaining laboratory testing (25.5%) and PrEP refills (either receipt of a refill authorization from a healthcare provider or processing of a refill from the pharmacy) (18.9%). 2-1-1 PrEP is an effective HIV prevention method; therefore, understanding facilitators and barriers of this dosing strategy can result in continuous provision of HIV prevention efforts, particularly during a pandemic.

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