The PrEP Care Continuum and Black Men Who Have Sex with Men: A Scoping Review of Published Data on Awareness, Uptake, Adherence, and Retention in PrEP Care

AIDS Behav. 2019 Oct;23(10):2654-2673. doi: 10.1007/s10461-019-02641-2.

Abstract

Pre-exposure prophylaxis (PrEP) has demonstrated high efficacy to reduce HIV infections, however, racial/ethnic HIV disparities continue among black MSM. The purpose of this review was to assess available data to inform interventions to increase PrEP awareness, uptake, and adherence among black MSM. Of the 3024 studies retrieved, 36 met final inclusion criteria and were categorized into the PrEP care continuum: (1) awareness (n = 16), (2) uptake (n = 9), and (3) adherence (n = 12). Only 26 of the studies presented analytical findings by race/ethnicity. Key barrier themes included cost, HIV-related stigma, and fear of potential side effects. A key facilitator theme identified by black MSM included gaining PrEP awareness from social and sexual networks. There are significant gaps in research on black MSM and PrEP utilization, especially regarding PrEP uptake and adherence. These data are needed to inform interventions to address current inequities in PrEP services, to help improve care outcomes for black MSM.

Keywords: Black; Continuum of care; HIV; Men who have sex with men; Pre-exposure prophylaxis.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Anti-HIV Agents / administration & dosage*
  • Anti-HIV Agents / therapeutic use
  • Awareness
  • Black or African American / psychology*
  • Black or African American / statistics & numerical data
  • Continuity of Patient Care*
  • HIV Infections / drug therapy
  • HIV Infections / prevention & control*
  • Health Knowledge, Attitudes, Practice*
  • Homosexuality, Male / ethnology
  • Homosexuality, Male / psychology
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / psychology*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Pre-Exposure Prophylaxis / statistics & numerical data*
  • Retention in Care
  • Sexual Behavior
  • Social Stigma

Substances

  • Anti-HIV Agents