The Motivational PrEP Cascade Guides Interpretation of Early PrEP Linkage to Care for Young Black Men Who Have Sex With Men: The Case of Chicago's PrEPLine

AIDS Educ Prev. 2019 Dec;31(6):491-504. doi: 10.1521/aeap.2019.31.6.491.


Pre-exposure prophylaxis (PrEP) uptake remains low among Black men who have sex with men (BMSM). PrEPLine, launched in August 2015, based in Chicago, was designed to support PrEP linkage among BMSM. PrEPLine moves clients through the Motivational PrEP Cascade, addresses barriers, and tracks outcomes. Study findings suggest that three variables (i.e., being gay/same gender loving, living more than 15 miles from a clinic location, rescheduling an appointment) demonstrated a significant positive association with initiating PrEP. A subanalysis of BMSM found that two variables (i.e., living on the West Side of Chicago relative to those living on the South Side, and among those living in communities with a higher rate of poverty [more than 30%], relative to those living in communities with a lower rate of poverty [less than 20%]) demonstrated a significant negative association with initiating PrEP.

Keywords: HIV prevention; PrEP; PrEP outcomes; motivational PrEP cascade; pre-exposure prophylaxis; stages of change.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-HIV Agents / administration & dosage*
  • Black People / psychology*
  • Black People / statistics & numerical data
  • Black or African American / psychology
  • Black or African American / statistics & numerical data
  • Chicago
  • HIV Infections / drug therapy
  • HIV Infections / prevention & control*
  • Health Knowledge, Attitudes, Practice
  • Health Services Accessibility
  • Homosexuality, Male / ethnology*
  • Homosexuality, Male / psychology
  • Homosexuality, Male / statistics & numerical data
  • Humans
  • Male
  • Motivation*
  • Patient Acceptance of Health Care
  • Poverty
  • Pre-Exposure Prophylaxis*
  • Residence Characteristics*
  • Socioeconomic Factors
  • Young Adult


  • Anti-HIV Agents