Facilitators and Barriers to Pre-Exposure Prophylaxis (PrEP) Use Among Black Individuals in the United States: Results from the National Survey on HIV in the Black Community (NSHBC)

AIDS Behav. 2018 Nov;22(11):3576-3587. doi: 10.1007/s10461-018-2067-8.

Abstract

This study explores willingness to use PrEP among Black individuals in the US. From February to April 2016, an online survey was administered to a nationally representative sample of Black individuals. 855 individuals who were HIV negative by self-report participated [mean age: 33.6 (SD 9.2); 45.5% male]. Among all respondents, 14.5% were aware of, and 26.0% would be willing to use PrEP. Among high-risk individuals (N = 327), 19.8% knew about and 35.1% would be willing to use PrEP. The most common reason for lack of willingness among high-risk individuals was low self-perceived risk (65.1%). In multivariate analysis, individuals reporting single marital status [OR 1.8 (1.2, 2.5), p = 0.002], depressive symptoms [OR 1.6 (1.2, 2.2), p = 0.0054], arrest history [OR 1.7(1.2, 2.4), p = 0.0003], PrEP knowledge [OR 1.5 (1.0, 2.3), p = 0.0247] and belief in HIV conspiracies [OR 1.3 (1.1, 1.5), p = 0.0075] were more willing to use PrEP. Participants who saw a health care provider less frequently were less willing to use PrEP [OR 0.5 (0.4, 0.8), p = 0.0044]. Among a nationally representative sample of Black individuals, few high risk individuals were willing to use PrEP. Interventions to increase risk awareness, PrEP knowledge and access to care are necessary to improve PrEP uptake.

Keywords: Black individuals in the US; HIV; HIV risk behavior; Pre-exposure prophylaxis.

MeSH terms

  • Adolescent
  • Adult
  • African Continental Ancestry Group / psychology*
  • Awareness
  • Cross-Sectional Studies
  • Female
  • HIV Infections / prevention & control*
  • HIV Infections / psychology
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Intention*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Patient Acceptance of Health Care / ethnology*
  • Patient Acceptance of Health Care / psychology
  • Patient Acceptance of Health Care / statistics & numerical data
  • Pre-Exposure Prophylaxis / methods*
  • Risk-Taking*
  • Self Report
  • Surveys and Questionnaires
  • United States
  • Young Adult