A Randomized Controlled Pilot Study of a Culturally-Tailored Counseling Intervention to Increase Uptake of HIV Pre-exposure Prophylaxis Among Young Black Men Who Have Sex with Men in Washington, DC
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Daily emtricitabine/tenofovor is effective at preventing HIV acquisition and is approved for HIV pre-exposure prophylaxis (PrEP). Blacks in the United States have a disproportionately high rate of HIV, and uptake of PrEP has been very low in this population. We conducted a pilot study in a high-prevalence city to test whether a culturally-tailored counseling center for young Black men who have sex with men (BMSM) positively impacted their access and uptake of PrEP. 50 young BMSM were randomized to either a PrEP counseling center group or a control group, and were then encouraged to obtain PrEP from a PrEP provider. At the end of 3 month study, six participants in the intervention group compared with none in the control group had initiated PrEP (p = 0.02). This pilot study demonstrates that a culturally-tailored counseling center might be an effective at increasing the uptake of PrEP in young BMSM.
KeywordsPreexposure prophylaxis HIV Counseling Black men who have sex with men
We acknowledge that all authors have contributed to this work and have seen and approved the manuscript. The contents of this manuscript have not been published and the manuscript is not being considered for publication elsewhere.
The study was funded by a Grant from the District of Columbia Center for AIDS Research (Grant: P30 AI117970-01).
Compliance with Ethical Standards
Conflict of interest
Author Marc Siegel has received research funding from Gilead Sciences for an unrelated research study. All other authors have no conflicts of interest.
Research Involving Human Participants
The study procedures and all materials were approved by the George Washington University Institutional Review Board and a Certificate of Confidentiality was obtained from the National Institutes of Health for studies with participants under 18 years of age. All study procedures have been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 1.CDC. Diagnoses of HIV infection in the United States and dependent areas, 2015. https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2015-vol-27.pdf.
- 2.District of Columbia Department of Health HIV/AIDS, Hepatitis, STD, and TB Administration. The annual epidemiology & surveillance report. 2017. https://doh.dc.gov/sites/default/files/dc/sites/doh/publication/attachments/HAHSTA%20Annual%20Report%202017%20-%20Final%20%282%29%20%282%29.pdf.
- 5.Centers for Disease Control and Prevention. Preexposure prophylaxis for the prevention of HIV infection in the United States—2014 clinical practice guideline. https://www.cdc.gov/hiv/pdf/PrEPguidelines2014.pdf.
- 8.Wheeler D, Fields S, Nelson L, et al. HPTN 073: PrEP uptake and use by black men who have sex with men in 3 US cities (abstract: 883LB). Presented at: The Conference on Retroviruses and Opportunistic Infections. Boston, MA; 2016.Google Scholar
- 9.Mera R, McCallister S, Palmer R, et al. Truvada (TVD) for HIV pre-exposure prophylaxis (PrEP) utilization in the United States (2013–2015). Presented at: 21st International AIDS Conference. Durban, South Africa; 2016.Google Scholar
- 10.Mera R, Magnuson D., Trevor H, Bush S, Rawlings K, McCallister S. Changes in Truvada (TVD) for HIV pre-exposure prophylaxis (PrEP) utilization in the United States: (2012–2016). Presented at: 9th IAS Conference on HIV Science. Paris, France; 2017.Google Scholar
- 11.Bush S, Magnuson D, Rawlings K, et al. Racial characteristics of FTC/TDF for pre-exposure prophylaxis (PrEP) users in the US. Presented at: American Society for Microbiology Microbe. Boston, MA; 2016.Google Scholar
- 12.Patrick R, Forrest D, Cardenas G, et al. Awareness, willingness, and use of pre-exposure prophylaxis among men who have sex with men in Washington, DC and Miami-Dade County, FL: National HIV Behavioral Surveillance, 2011 and 2014. J Acquir Immune Defic Syndr. 2017;75(Suppl 3):S375–82.CrossRefGoogle Scholar
- 13.Levy M, Magnus M, Kuo I, et al. An evaluation of the PrEP care continuum among men who have sex with men aged 16-25 in Washington, DC. Presented at: HIV Research for Prevention. Chicago, IL; 2016.Google Scholar
- 17.Centers for Disease Control and Prevention. Reportable STDs in young people 15–24 years of age, by state. https://www.cdc.gov/std/stats/by-age/15-24-all-stds/default.htm.
- 20.Smith D, Van Handel M, Wolitski R, et al. Vital signs: estimated percentages and numbers of adults with indications for preexposure prophylaxis to prevent hiv acquisition-United States, 2015. J Miss State Med Assoc. 2015;56(12):364–71.Google Scholar