Matthew C Sullivan1, Lisa A Eaton2. 1. Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269-1020, USA. matthew.c.sullivan@uconn.edu. 2. Department of Human Development and Family Studies, University of Connecticut, Storrs, CT, USA.
Abstract
BACKGROUND: Pre-exposure prophylaxis (PrEP) can sharply reduce HIV transmission risk, yet has not been widely adopted among those at highest risk for HIV, including Black men who have sex with men (BMSM). To better understand the evolving landscape of PrEP uptake in this at-risk population, we sought to examine psychosocial factors associated with PrEP uptake in a sample of BMSM residing in the Atlanta, GA, area. METHOD: BMSM were recruited through online social media, LGBT venues, and participant referral, and self-reported demographic and psychosocial information via computer-assisted self-interview. Multivariate logistic regression was used to examine psychosocial factors associated with PrEP uptake. RESULTS: In 293 BMSM, most (N = 260; 88.7%) reported awareness of PrEP yet few (N = 30; 10.1%) reported ever having taken PrEP. BMSM reporting more syndemic conditions were less likely to be current PrEP users (OR = 0.59; 95% CI: 0.36, 0.96). BMSM reporting recent condomless anal sex (CAS) with a partner met online (adjusted odds ratio (aOR) = 2.53; 95% CI: 1.07, 5.93), or who reported having chlamydia (aOR = 8.21; 95% CI: 1.42, 47.67) or STI-related symptoms (aOR = 4.35; 95% CI: 1.32, 14.37) in the past 3 months, or genital warts in their lifetime (aOR = 7.74; 95% CI: 2.47, 24.21) were more likely to have ever used PrEP. Sexual orientation stigma from health care providers was negatively associated with PrEP uptake (OR = 0.81, 95% CI: 0.68, 0.95) among BMSM reporting recent CAS and multiple partners. CONCLUSION: Syndemic and stigma theories may inform strategies for improving PrEP uptake in BMSM.
BACKGROUND: Pre-exposure prophylaxis (PrEP) can sharply reduce HIV transmission risk, yet has not been widely adopted among those at highest risk for HIV, including Black men who have sex with men (BMSM). To better understand the evolving landscape of PrEP uptake in this at-risk population, we sought to examine psychosocial factors associated with PrEP uptake in a sample of BMSM residing in the Atlanta, GA, area. METHOD: BMSM were recruited through online social media, LGBT venues, and participant referral, and self-reported demographic and psychosocial information via computer-assisted self-interview. Multivariate logistic regression was used to examine psychosocial factors associated with PrEP uptake. RESULTS: In 293 BMSM, most (N = 260; 88.7%) reported awareness of PrEP yet few (N = 30; 10.1%) reported ever having taken PrEP. BMSM reporting more syndemic conditions were less likely to be current PrEP users (OR = 0.59; 95% CI: 0.36, 0.96). BMSM reporting recent condomless anal sex (CAS) with a partner met online (adjusted odds ratio (aOR) = 2.53; 95% CI: 1.07, 5.93), or who reported having chlamydia (aOR = 8.21; 95% CI: 1.42, 47.67) or STI-related symptoms (aOR = 4.35; 95% CI: 1.32, 14.37) in the past 3 months, or genital warts in their lifetime (aOR = 7.74; 95% CI: 2.47, 24.21) were more likely to have ever used PrEP. Sexual orientation stigma from health care providers was negatively associated with PrEP uptake (OR = 0.81, 95% CI: 0.68, 0.95) among BMSM reporting recent CAS and multiple partners. CONCLUSION: Syndemic and stigma theories may inform strategies for improving PrEP uptake in BMSM.
Entities:
Keywords:
African Americans; Men who have sex with men; Pre-exposure prophylaxis; Sexually transmitted infections; Syndemic
Authors: Robert M Grant; Javier R Lama; Peter L Anderson; Vanessa McMahan; Albert Y Liu; Lorena Vargas; Pedro Goicochea; Martín Casapía; Juan Vicente Guanira-Carranza; Maria E Ramirez-Cardich; Orlando Montoya-Herrera; Telmo Fernández; Valdilea G Veloso; Susan P Buchbinder; Suwat Chariyalertsak; Mauro Schechter; Linda-Gail Bekker; Kenneth H Mayer; Esper Georges Kallás; K Rivet Amico; Kathleen Mulligan; Lane R Bushman; Robert J Hance; Carmela Ganoza; Patricia Defechereux; Brian Postle; Furong Wang; J Jeff McConnell; Jia-Hua Zheng; Jeanny Lee; James F Rooney; Howard S Jaffe; Ana I Martinez; David N Burns; David V Glidden Journal: N Engl J Med Date: 2010-11-23 Impact factor: 91.245
Authors: Latesha Elopre; Kachina Kudroff; Andrew O Westfall; Edgar T Overton; Michael J Mugavero Journal: J Acquir Immune Defic Syndr Date: 2017-01-01 Impact factor: 3.731
Authors: Lisa A Eaton; Daniel D Driffin; Harlan Smith; Christopher Conway-Washington; Denise White; Chauncey Cherry Journal: Sex Health Date: 2014-07 Impact factor: 2.706
Authors: Derrick D Matthews; A L Herrick; Robert W S Coulter; M Reuel Friedman; Thomas C Mills; Lisa A Eaton; Patrick A Wilson; Ron D Stall Journal: AIDS Behav Date: 2016-01
Authors: Sarah K Calabrese; Valerie A Earnshaw; Douglas S Krakower; Kristen Underhill; Wilson Vincent; Manya Magnus; Nathan B Hansen; Trace S Kershaw; Kenneth H Mayer; Joseph R Betancourt; John F Dovidio Journal: AIDS Behav Date: 2018-04
Authors: Sarah K Calabrese; Sharanya Rao; Adam I Eldahan; Mehrit Tekeste; Djordje Modrakovic; D Dangaran; Cheriko A Boone; Kristen Underhill; Douglas S Krakower; Kenneth H Mayer; Nathan B Hansen; Trace S Kershaw; Manya Magnus; Joseph R Betancourt; John F Dovidio Journal: Arch Sex Behav Date: 2022-07-05
Authors: Nioud Mulugeta Gebru; Maria Costanza Benvenuti; Bonnie H P Rowland; Meher Kalkat; Patricia G Chauca; Robert F Leeman Journal: Subst Use Misuse Date: 2022-02-21 Impact factor: 2.362
Authors: Cheríe S Blair; Jack Needleman; Marjan Javanbakht; W Scott Comulada; Amy Ragsdale; Robert Bolan; Steven Shoptaw; Pamina M Gorbach Journal: J Urban Health Date: 2022-01-14 Impact factor: 5.801