AIDS and Behavior

, Volume 22, Issue 11, pp 3576–3587 | Cite as

Facilitators and Barriers to Pre-Exposure Prophylaxis (PrEP) Use Among Black Individuals in the United States: Results from the National Survey on HIV in the Black Community (NSHBC)

  • Bisola O. OjikutuEmail author
  • Laura M. Bogart
  • Molly Higgins-Biddle
  • Sannisha K. Dale
  • Wanda Allen
  • Tiffany Dominique
  • Kenneth H. Mayer
Original Paper


This study explores willingness to use PrEP among Black individuals in the US. From February to April 2016, an online survey was administered to a nationally representative sample of Black individuals. 855 individuals who were HIV negative by self-report participated [mean age: 33.6 (SD 9.2); 45.5% male]. Among all respondents, 14.5% were aware of, and 26.0% would be willing to use PrEP. Among high-risk individuals (N = 327), 19.8% knew about and 35.1% would be willing to use PrEP. The most common reason for lack of willingness among high-risk individuals was low self-perceived risk (65.1%). In multivariate analysis, individuals reporting single marital status [OR 1.8 (1.2, 2.5), p = 0.002], depressive symptoms [OR 1.6 (1.2, 2.2), p = 0.0054], arrest history [OR 1.7(1.2, 2.4), p = 0.0003], PrEP knowledge [OR 1.5 (1.0, 2.3), p = 0.0247] and belief in HIV conspiracies [OR 1.3 (1.1, 1.5), p = 0.0075] were more willing to use PrEP. Participants who saw a health care provider less frequently were less willing to use PrEP [OR 0.5 (0.4, 0.8), p = 0.0044]. Among a nationally representative sample of Black individuals, few high risk individuals were willing to use PrEP. Interventions to increase risk awareness, PrEP knowledge and access to care are necessary to improve PrEP uptake.


HIV Black individuals in the US Pre-exposure prophylaxis HIV risk behavior 



We would like to thank Felton Earls MD, Professor Emeritus at Harvard T. H. Chan School of Public Health and Harvard Medical School, for providing leadership for this study. We would also like to thank the members of the national advisory committee whose input in survey development was instrumental.


This study was funded by the National Institutes of Mental Health (K23 MH107316—Ojikutu), the Harvard University Center for AIDS Research (P30 AI060354-Mayer, Bogart and Ojikutu), the UCLA Center for HIV Identification, Prevention, and Treatment Services (P30MH058107—Bogart), and the Center for AIDS Research Perelman School of Medicine, University of Pennsylvania (P30 AI045008—Dominique).

Compliance with Ethical Standards

Conflict of interest

None of the authors report conflict of interest.

Ethical Approval

All procedures performed in this study were in accordance with the ethical standards of the institution and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants in this study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Bisola O. Ojikutu
    • 1
    • 4
    Email author
  • Laura M. Bogart
    • 2
  • Molly Higgins-Biddle
    • 3
  • Sannisha K. Dale
    • 4
    • 5
  • Wanda Allen
    • 6
  • Tiffany Dominique
    • 7
  • Kenneth H. Mayer
    • 8
  1. 1.Brigham and Women’s HospitalBostonUSA
  2. 2.RAND CorporationSanta MonicaUSA
  3. 3.JSI Research and Training InstituteBostonUSA
  4. 4.Massachusetts General HospitalBostonUSA
  5. 5.University of MiamiCoral GablesUSA
  6. 6.Harvard UniversityBostonUSA
  7. 7.University of PennsylvaniaPhiladelphiaUSA
  8. 8.The Fenway InstituteBostonUSA

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