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Sleep Disturbance is Associated with Missing PrEP Doses Among Young Black Sexual Minority Men in The N2 study


PrEP uptake and adherence among young Black sexual minority men (YBSMM), has been sub-optimal. Multiple studies identified sleep as an important determinant of medication adherence, although it has not been examined with regard to PrEP among YBSMM. This study utilized data collected from HIV-negative cisgender YBSMM in the Neighborhoods and Networks (N2) study in Chicago using PrEP (N = 70). Sleep quality was measured using the PHQ-9 and PrEP adherence questions were adapted from Reynolds et al., 2004. Bivariate and multivariable regression analyses were used to estimate associations between sleep and missing PrEP doses, controlling for relevant demographic and behavioral factors. YBSMM who reported sleep disturbance a moderate amount of time (aOR 7.59 [1.05 to 54.57]) were more likely to miss taking PrEP because they had too many pills to take. Sleep quality is an overlooked determinant of medication adherence, and may negatively impact YBSMM’s ability to consistently take PrEP.

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Availability of Data and Material

The data underlying the results presented in the study are available upon request from Jade Pagkas-Bather:

Code Availability

All data were analyzed using Stata 15, College Station, Texas.


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We would like to thank the participants of the N2 study, and the NIH for funding this work (R01MH112406 PIs Duncan and Schneider).


This research was supported by the NIH.

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Authors and Affiliations



JPB designed the study, wrote the manuscript, and did some of the statistical analysis. JC did most of the statistical analysis. DTD, YC, NDV, KHM, JK, HH, RE, and JAS provided input and edits to the manuscript.

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Correspondence to Jade Pagkas-Bather.

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This research was approved by The University of Chicago Biological Sciences Division/University of Chicago Medical Center IRB16-1419-CR004.

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All study participants provided written consent at the time of their study visit.

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Participants consented that N2 data would be used for publication and scientific communication.

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Pagkas-Bather, J., Duncan, D.T., Chen, YT. et al. Sleep Disturbance is Associated with Missing PrEP Doses Among Young Black Sexual Minority Men in The N2 study. AIDS Behav (2022).

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  • PrEP
  • HIV
  • Sleep