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Identifying Barriers to PrEP Uptake in Black Men Living in a Rural Setting

A team of investigators from Indiana University set out to examine levels of PrEP awareness among black men in a rural midwestern city to identify barriers and facilitators to PrEP uptake and access.

HIV prevention has come a long way in the recent past, yet black men continue to be disproportionately affected by the HIV epidemic. While pre-exposure prophylaxis (PrEP) is an important tool in the fight against HIV and has been proven to be efficacious in prevention acquisition, uptake remains low among black men.

With this in mind a team of investigators from Indiana University in Bloomington, Indiana set out to examine levels of PrEP awareness among black men in a rural midwestern city to identify barriers and facilitators to PrEP uptake and access. Their results were presented in a poster session at the Association of Nurses in AIDS Care Conference (ANAC 2019).

For the study, the investigators administered a cross-sectional survey of 67 close-ended questions to black men living in the Bloomington area. The participants’ mean age category was 25-34 years. In total 111 surveys were eligible for analysis via logistic regression analysis.

The study looked at knowledge of PrEP as the outcome variable and 5 additional predictor variables which included comfort level using birth control other than condoms; accepting diversity in sexual orientation; sexual identification; comfort practicing sexual abstinence; and satisfaction with their health care provider.

The investigators report that the overall correct classification rate was 75%. Further, the predictor values of accepting diversity in sexual orientation (P = .008) and comfort using birth control other than condoms (P = .02), and the demographic predictor value of sexual identification (P = .01), and the health care provider satisfaction variable (P = .003) yielded significant results.

Results indicate that black men who have sex with men are 4.59 times more likely to be aware of PrEP. On the other hand, black men who were not comfortable in accepting sexual orientation diversity are 4.44 times less likely to be aware of PrEP.

Black men who were dissatisfied with their provider are 4.02 times less likely to be aware of PrEP. Lastly, black men comfortable using birth control other than condoms are 3.69 times less likely to be aware of PrEP.

The abstract authors are hopeful that their findings may help clinicians understand how sexual identification impacts PrEP use and write, “Our findings suggest by improving the degree of acceptance of diversity in sexual identification among black men may strengthen results in HIV prevention interventions.”

The abstract, Awareness of pre-exposure prophylaxis for HIV prevention among black men in a moderately rural midwestern city, was presented in a poster presentation on Thursday, November 7, at ANAC 2019 in Portland, Oregon.