Predictors of PrEP Uptake by Black Gay and Bisexual Men in Ohio

Abstract

The association between preexposure prophylaxis (PrEP) stigma, PrEP knowledge, medical mistrust, and the adoption of PrEP was examined in a sample of 123 self identified HIV-negative adult black gay and bisexual men in the state of Ohio. Age, highest level of education attained, and annual income of the participants were identified as possible confounders and accounted for using binary logistic regression. This research is grounded in the information motivation behavioral skills model, which is used to explain how various factors work together to affect health behavior. African American men who have sex with men, who were disproportionally affected by the epidemic, were the least likely to adopt PrEP when compared with other ethnic or racial populations. There was a 61.5% decrease in the adoption likelihood with each one unit increase in stigma. A statistically significant and positive association existed between PrEP knowledge and the willingness to adopt PrEP, with a 271.2% increased likelihood of PrEP adoption per unit increase in knowledge. PrEP adoption has the potential to reduce health inequality for black gay and bisexual men. Implications for positive social change include policymakers and public health providers designing culturally competent policies and programs with consideration for stigma, knowledge, and inherent mistrust; such polices and programs can improve the health and lives for this at-risk group of men