Corina Lelutiu-Weinberger1, Sarit A Golub. 1. *Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY; and †Department of Psychology, Basic and Applied Social Psychology PhD Program, The Graduate Center of the City University of New York (CUNY), New York, NY.
Abstract
OBJECTIVE: Implementation of HIV pre-exposure prophylaxis (PrEP) programs for populations with highest incidence is critical to reducing new infections in the United States. Black and Latino men who have sex with men (BLMSM) are disproportionately burdened by HIV. We examined differences in perceived barriers and facilitators to PrEP access for BLMSM compared with other men who have sex with men (MSM). METHOD: MSM who met the Centers for Disease Control and Prevention criteria for PrEP (n = 491) completed measures of barriers and facilitators to PrEP at the systems, provider, and individual levels. Multivariate analyses examined differences by race/ethnicity, adjusting for other sociodemographic factors. RESULTS: Compared with other MSM, BLMSM (56% of the sample) were more likely to have public insurance and to access health care via public clinics [adjusted odds ratio(aOR) 3.2, P < 0.001; aOR 2.4, P < 0.01]. BLMSM were more likely to regard having to talk to their doctor about their sex life as a barrier to PrEP (aOR 3.7, P < 0.001) and were less likely to endorse agency in medical decision making (aOR 0.58, P < 0.001). BLMSM were more likely to report PrEP stigma (aOR 2.3, P < 0.001) and concerns regarding PrEP efficacy (aOR 1.6, P < 0.05). BLMSM were more likely to consider access to free sexual health care (aOR 2.1, P < 0.01) and additional supportive services, eg, counseling (aOR 3.1, P < 0.001) or text-based support (aOR 2.9, P < 0.001) to be significant facilitators of PrEP use. CONCLUSIONS: Findings suggest specific points of multilevel intervention to increase PrEP access for BLMSM and increase representation of BLMSM along the PrEP continuum of care.
OBJECTIVE: Implementation of HIV pre-exposure prophylaxis (PrEP) programs for populations with highest incidence is critical to reducing new infections in the United States. Black and Latino men who have sex with men (BLMSM) are disproportionately burdened by HIV. We examined differences in perceived barriers and facilitators to PrEP access for BLMSM compared with other men who have sex with men (MSM). METHOD: MSM who met the Centers for Disease Control and Prevention criteria for PrEP (n = 491) completed measures of barriers and facilitators to PrEP at the systems, provider, and individual levels. Multivariate analyses examined differences by race/ethnicity, adjusting for other sociodemographic factors. RESULTS: Compared with other MSM, BLMSM (56% of the sample) were more likely to have public insurance and to access health care via public clinics [adjusted odds ratio(aOR) 3.2, P < 0.001; aOR 2.4, P < 0.01]. BLMSM were more likely to regard having to talk to their doctor about their sex life as a barrier to PrEP (aOR 3.7, P < 0.001) and were less likely to endorse agency in medical decision making (aOR 0.58, P < 0.001). BLMSM were more likely to report PrEP stigma (aOR 2.3, P < 0.001) and concerns regarding PrEP efficacy (aOR 1.6, P < 0.05). BLMSM were more likely to consider access to free sexual health care (aOR 2.1, P < 0.01) and additional supportive services, eg, counseling (aOR 3.1, P < 0.001) or text-based support (aOR 2.9, P < 0.001) to be significant facilitators of PrEP use. CONCLUSIONS: Findings suggest specific points of multilevel intervention to increase PrEP access for BLMSM and increase representation of BLMSM along the PrEP continuum of care.
Authors: Lisa R Metsch; Margaret Pereyra; Carlos del Rio; Lytt Gardner; Wayne A Duffus; Gordon Dickinson; Peter Kerndt; Pamela Anderson-Mahoney; Steffanie A Strathdee; Alan E Greenberg Journal: Am J Public Health Date: 2004-07 Impact factor: 9.308
Authors: Mary Catherine Beach; Eboni G Price; Tiffany L Gary; Karen A Robinson; Aysegul Gozu; Ana Palacio; Carole Smarth; Mollie W Jenckes; Carolyn Feuerstein; Eric B Bass; Neil R Powe; Lisa A Cooper Journal: Med Care Date: 2005-04 Impact factor: 2.983
Authors: Yolanda H Wimberly; Matthew Hogben; Jada Moore-Ruffin; Sandra E Moore; Yvonne Fry-Johnson Journal: J Natl Med Assoc Date: 2006-12 Impact factor: 1.798
Authors: Yumeng Wu; Lu Xie; Siyan Meng; Jianhua Hou; Rong Fu; Huang Zheng; Na He; Kathrine Meyers Journal: LGBT Health Date: 2019-06-06 Impact factor: 4.151
Authors: Charlotte-Paige Rolle; Eli S Rosenberg; Aaron J Siegler; Travis H Sanchez; Nicole Luisi; Kevin Weiss; Scott Cutro; Carlos Del Rio; Patrick S Sullivan; Colleen F Kelley Journal: J Acquir Immune Defic Syndr Date: 2017-11-01 Impact factor: 3.731
Authors: Sarah K Calabrese; John F Dovidio; Mehrit Tekeste; Tamara Taggart; Rachel W Galvao; Cara B Safon; Tiara C Willie; Abigail Caldwell; Clair Kaplan; Trace S Kershaw Journal: J Acquir Immune Defic Syndr Date: 2018-09-01 Impact factor: 3.731
Authors: Lisa A Eaton; Derrick D Matthews; Leigh A Bukowski; M Ruvel Friedman; Cristian J Chandler; Darren L Whitfield; Jordan M Sang; Ron D Stall Journal: J Acquir Immune Defic Syndr Date: 2018-11-01 Impact factor: 3.731
Authors: Gordon Mansergh; Brittney N Baack; Jeremy Holman; Matthew J Mimiaga; Stewart Landers; Jeffrey H Herbst Journal: J Acquir Immune Defic Syndr Date: 2019-01-01 Impact factor: 3.731
Authors: Kellie Schueler; Matthew Ferreira; Georgios Nikolopoulos; Britt Skaathun; Dimitrios Paraskevis; Angelos Hatzakis; Samuel R Friedman; John A Schneider Journal: AIDS Behav Date: 2019-07