Predictors of Pre-exposure Prophylaxis Awareness among African American Young Adults in Louisville, Kentucky.

Low pre-exposure prophylaxis (PrEP; medication to reduce HIV risk among HIV-negative people) awareness may be partially responsible for racial/ethnic differences in treatment uptake. Little research has examined PrEP awareness among African Americans with diverse HIV risk profiles. Audio computer-assisted self-interviews were distributed to 204 African American young adults (age 18-29) demonstrating heightened HIV vulnerability. Chi square analysis and logistic regressions were conducted to determine factors associated with PrEP awareness. While unadjusted logistic regression indicates that age 18-21 years (p<.01), heterosexuality (p<.05), lower education (p<.05), less frequent HIV testing (p<.01), STI diagnosis history (p<.05), not having casual sex (p<.05), and not having a one night stand (p<.01) were associated with decreased PrEP awareness, only heterosexuality (p<.05), lower education (p<.05), and less HIV testing (p<.01) remained significant in adjusted analysis. PrEP-focused education efforts should include outreach across education gradients and sexual orientations. Counselling efforts included with HIV testing may be responsible for accelerating PrEP knowledge among testers.

A Qualitative Exploration of Various Stigmas Impacting HIV Pre-Exposure Prophylaxis (PrEP) Uptake Among African American Young Adults.

Pre-exposure prophylaxis (PrEP) has promise for reducing racial/ethnic HIV disparities; yet, acceptance among African Americans remains low. PrEP-related stigmas may impact uptake, but this is understudied. This study examines mechanisms by which stigma impacts PrEP acceptance among various priority African American populations. Focus group data from 63 African American young adults (aged 18-29 years) in Louisville, Kentucky, explore how various stigmas impact attitudes toward PrEP. Data were analyzed using grounded theory analytic techniques. PrEP stigma, HIV stigma, sexual behavior stigma, and homophobia/transphobia individually reduce PrEP uptake. These stigmas also interact synergistically to undermine PrEP acceptance. Key challenges resulting from various stigmas and their interactions include medical hesitancy, lack of perceived susceptibility based on gender and sexuality, the role of gender norms in HIV prevention, and deprioritizing HIV prevention due to social rejection. Interventions to increase awareness, destigmatize PrEP, remediate social marginalization related to identity, HIV status, and gendered perceptions of sexual risk, as well as more focus on diverse priority groups, are needed to present PrEP as a viable HIV prevention option for African American communities. More research is needed to optimize strategies that address stigma and increase acceptance of novel HIV prevention technologies.

Examining HIV-related stigma among African, Caribbean, and Black church congregants from the Black PRAISE study in Ontario, Canada.

HIV-related stigma impedes adoption and implementation of effective HIV prevention and treatment strategies. It may also exacerbate racial/ethnic HIV disparities. Given high levels of religious observance within African, Caribbean, and Black (ACB) communities and the social capital that faith-based organizations hold, these entities may be promising venues for stigma-remediation and effective partners in community-based, HIV-focused programing. However, more research is needed to understand HIV-related stigma in these institutions. This study examines HIV-related stigma among six ACB churches in Ontario, Canada. Surveys were distributed to ACB attendees (N = 316) and linear regressions determined relationships between HIV-related stigma and stigma subdomains with demographics, greater disagreement with same-sex relationships, HIV knowledge, and religiosity. Greater disagreement with same-sex relationships was the only variable associated with the HIV-related stigma scale and all of its subscales. Age, gender, HIV knowledge, religiosity, contact with persons living with HIV, and length of time in Canada were associated with varying aspects of HIV-related stigma. Findings can inform the development of HIV-related stigma interventions and the characteristics of individuals these efforts should target to achieve maximum impact.

Community-Informed Development of a Campaign to Increase HIV Pre-exposure Prophylaxis (PrEP) Awareness Among African-American Young Adults.

Pre-exposure prophylaxis (PrEP) for HIV prevention can help reduce racial/ethnic HIV disparities in the USA. However, the benefits of PrEP have not been equally distributed across races. Community-informed, culturally tailored media has the potential to increase PrEP awareness and acceptability among vulnerable African-American populations. More research is needed to identify media preferences around PrEP for these groups in order to optimize effectiveness of health messaging. This study details the development of a community-informed multimedia (print, digital, Internet radio, website, social media) campaign to increase PrEP awareness among African-American young adults (age 18-29 years). Eleven focus groups with African-American young adults and a community advisory board informed the intervention. Focus group participants expressed concerns with PrEP safety, efficacy, accessibility, the universality of HIV vulnerability, and representation. Campaign elements were then developed based on this feedback. Future studies should examine the effectiveness of culturally tailored multimedia PrEP campaigns.