Assessing the Knowledge and Attitudes of Black/African American Men who have Sex with Men on HIV Pre-Exposure Prophylaxis

Background: African American men who have sex with men (MSM) represent 37% of the HIV incidence among all MSM and young Black MSM observed a significant increase of 48% in new infections during 2006-2009. There were 6,500 infections in Black MSM aged 13-29 exceeding the number of infections of White MSM aged 13-29 and 30-39 combined. In 2010, results from the Global iPrEX clinical trial showed 44% efficacy of oral pre-exposure prophylaxis among MSM. The implementation of PrEP as a HIV prevention tool may have positive implications in reducing the disparity of HIV infection among Black MSM.\ud Methods: Participants were recruited and sampled for an online survey using the social networking sites Facebook and Twitter. Eligibility for participation was contingent upon self-reported response as Black/African American, an MSM, HIV negative or unaware of HIV status, and over 18 years of age. Informed consent was obtained. Behavioral data was collected from participants on sexual behaviors, HIV testing, and self-perceived susceptibility to HIV infection. Participants were asked specifically their knowledge of PrEP and likeliness of using PrEP to reduce risk of HIV infection.\ud Results: The sample pre-eligibility included 178 respondents. 20.5% (32) respondents reported being HIV positive. After eligibility was determined 99 respondents were included in the analysis. 56.4% of the sample reported having little or no knowledge of PrEP yet would use PrEP to reduce their risk of HIV infection. Age was the strongest indicator of all the independent variables on PrEP acceptance being statistically significant in all models of the regression analysis. \ud Conclusions: Contrary to the original hypothesis, an inverse relationship between PrEP knowledge and acceptance was ascertained in the current study. Some possible explanations for this interesting finding are that respondents were unaware of the risks and benefits of pre-exposure prophylaxis and were concerned about preventing themselves from contracting HIV. Also if respondents were to use PrEP, it would likely have to be at little or no individual out of pocket costs. There are a number of factors influencing such high acceptance of PrEP among Black MSM and the current study was able to ascertain some of these factors. These findings have public health significance to the current epidemiology of HIV infection in the United States and further prevention efforts.\u