AIDS and Behavior

, Volume 23, Issue 10, pp 2694–2705 | Cite as

Prevalence and Correlates of PrEP Awareness and Use Among Black Men Who Have Sex with Men and Women (MSMW) in the United States

  • M. Reuel FriedmanEmail author
  • Jordan M. Sang
  • Leigh A. Bukowski
  • Cristian J. Chandler
  • James E. Egan
  • Lisa A. Eaton
  • Derrick D. Matthews
  • Ken Ho
  • Henry F. Raymond
  • Ron Stall
Original Paper


Men who have sex with men and women (MSMW), including those who are Black, experience HIV-related disparities compared to men who have sex with men only (MSMO). Few studies have assessed the prevalence and correlates of pre-exposure prophylaxis (PrEP) awareness and use among Black MSMW. We recruited MSM ≥ 18 attending Black Gay Pride events between 2014–2017. We conducted multivariable logistic regressions to assess differences in PrEP awareness and use among HIV-negative Black MSM (n = 2398) and within Black MSMW (n = 419). MSMW were less likely than MSMO to report PrEP awareness (p < 0.001). Among PrEP-aware MSM, MSMW were more likely than MSMO to report PrEP use (p < 0.05). MSMW receiving gay community support were more likely to be PrEP-aware (p < 0.01). MSMW reporting any past-year STI diagnoses were more likely to report PrEP use (p < 0.01). Findings suggest that PrEP awareness campaigns tailored for Black MSMW, concomitant with STI-to-PrEP interventions, will facilitate greater PrEP uptake in this population.


HIV prevention Pre-exposure prophylaxis Black/African American Men who have sex with men (MSM) Bisexuality 


Los hombres que tienen sexo con hombres y mujeres (MSMW, siglas in Inglés), incluyendo los que son Negros, experimentan disparidades relacionadas con el VIH en comparación con los hombres que tienen sexo con hombres solamente (MSMO, siglas en Inglés). Pocos estudios han evaluado la prevalencia y los correlatos de el conocimiento y el uso de la profilaxis pre-exposición (PrEP, siglas in Inglés) entre los MSMW Negros. Reclutamos a hombres que tienen sexo con hombres, o MSM (siglas en Inglés) ≥18 que asistieron a eventos del Orgullo Gay Negro entre 2014—2017. Realizamos regresiones logísticas multivariables para evaluar las diferencias en el conocimiento y uso de PrEP entre los MSM Negros VIH-negativos (n=2398) y dentro de los MSMW Negros (n=419). Los MSMW fueron menos probables que los MSMO a reportar sobre el conocimiento de la PrEP (p<.001). Entre los MSM con reconocimiento de PrEP, los MSMW fueron más probables que los MSMO a reportar el uso de PrEP (p<.05). Los MSMW que recibieron apoyo de la comunidad gay tenían más probabilidades de ser conscientes de la PrEP (p<.01). Los MSMW que informaron sobre cualquier diagnóstico de ITS el año anterior tenían más probabilidades de informar el uso de PrEP (p <.01). Los hallazgos sugieren que las campañas de concientización sobre la PrEP adaptadas para los MSMW Negros, concomitantes con las intervenciones de ITS-a-PrEP, facilitarán una mayor captación de PrEP en esta populación.



The authors thank the Center for Black Equity and local Black Pride organizations for partnering with us to implement POWER, the community-based organizations who performed onsite HIV testing on the study’s behalf, the thousands of study participants who volunteered their time to contribute to this research, and members of the POWER Study Team who made data collection possible. The local Black Pride organizations are as follows: D.C. Black Pride, Detroit’s Hotter than July, Houston Splash, In the Life Atlanta, Memphis Black Pride, and Philadelphia Black Pride. The community-based organizations that performed onsite HIV testing are as follows: Atlanta: AID Atlanta, AIDS Health Care Foundation, NAESM; Detroit: Community Health Awareness Group, Horizons Project, Unified; Houston: Avenue 360, Houston AIDS Foundation, Positive Efforts; Memphis: Friends for Life; Philadelphia: Access Matters, Philadelphia FIGHT; Washington, D.C.: Us Helping Us. The members of POWER study team are as follows: Center for Black Equity: Earl D. Fowlkes, Jr., Michael S. Hinson, Jr.; Columbia University: Patrick A. Wilson; University of Connecticut: Lisa A. Eaton; Rutgers University: Henry Fisher-Raymond; University of Pittsburgh: Leigh A. Bukowski, Cristian J. Chandler, Derrick D. Matthews, Steven P. Meanley, Jordan M. Sang, and Ronald D. Stall. We are grateful to Luis Archila for his translation of our abstract into Spanish.


This study was funded by the National Institutes of Minority Health and Health Disparities, National Institutes of Health (5R01NR013865).

Compliance with Ethical Standards

Conflict of interest

Author MRF has received an honorarium and travel expenses reimbursement for serving as a consultant to Gilead Sciences, Inc. in June 2018 for the purposes of providing scientific input for a grant mechanism in development concentrating on HIV and aging. Authors MRF and RDS received travel expenses reimbursements from Gilead Sciences, Inc. for the purposes of speaking at AIDSImpact conference in July 2015, specifically for a symposium on syndemics and the HIV prevention and care continuum. Authors JMS, LAB, DDM, LAE, CJC, JEE, KH, and HRF have no conflicts of interest to declare.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the University of Pittsburgh Human Research Protection Office (protocol number PRO13110137).

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

10461_2019_2446_MOESM1_ESM.pdf (156 kb)
Supplementary material 1 (PDF 155 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • M. Reuel Friedman
    • 1
    • 2
    Email author
  • Jordan M. Sang
    • 2
    • 3
  • Leigh A. Bukowski
    • 2
    • 3
  • Cristian J. Chandler
    • 4
  • James E. Egan
    • 2
    • 3
  • Lisa A. Eaton
    • 5
  • Derrick D. Matthews
    • 6
  • Ken Ho
    • 7
  • Henry F. Raymond
    • 8
  • Ron Stall
    • 2
    • 3
  1. 1.Department of Infectious Diseases and Microbiology, Graduate School of Public HealthUniversity of PittsburghPittsburghUSA
  2. 2.Center for LGBT Health Research, Graduate School of Public HealthUniversity of PittsburghPittsburghUSA
  3. 3.Department of Behavioral and Community Health Sciences, Graduate School of Public HealthUniversity of PittsburghPittsburghUSA
  4. 4.Department of Epidemiology, Rollins School of Public HealthEmory UniversityAtlantaUSA
  5. 5.Department of Human Development and Family StudiesUniversity of ConnecticutHartfordUSA
  6. 6.Department of Health Behavior, Gillings School of Global Public HealthUniversity of North CarolinaChapel HillUSA
  7. 7.Division of Infectious Diseases, School of MedicineUniversity of PittsburghPittsburghUSA
  8. 8.Department of Biostatistics and Epidemiology, School of Public HealthRutgers UniversityPiscatawayUSA

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