Unmet HIV Service Needs Among Black Men Who Have Sex with Men in the United States

Holtgrave, David R.; Kim, J. Janet; Adkins, Chris; Maulsby, Cathy; Lindsey, Kali; Johnson, Kelsey; Montoya, Daniel; Kelley, Robin

doi:10.1007/s10461-013-0574-1

Cited by 22 publications

(13 citation statements)

References 10 publications

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“…Although historically much of the HIV prevention and treatment efforts in the US have been carried out by community-based HIV/ AIDS organizations, many of these agencies are likely unequipped within their currently existing infrastructure to not only raise awareness of PrEP, but seek out, engage, and provide ongoing care for individuals who are on PrEP or candidates for PrEP. This scenario leaves open the need to either enhance and improve services provided by HIV/AIDS medical providers, [44][45][46] or to train primary care providers in sexual health assessments and CDC guidelines on PrEP use, and invigorate efforts to promote PrEP. Further, our study focused primarily on challenges relating to awareness of PrEP.…”

Section: Prep Awareness Among Bmsm 427mentioning

confidence: 99%

Minimal Awareness and Stalled Uptake of Pre-Exposure Prophylaxis (PrEP) Among at Risk, HIV-Negative, Black Men Who Have Sex with Men

Eaton

Driffin

Bauermeister

et al. 2015

AIDS Patient Care and STDs

230

168

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In the United States, rates of HIV infection are highest among black men who have sex with men (BMSM). Preexposure prophylaxis (PrEP) is a highly effective form of HIV prevention, but the uptake of this strategy has been slow since FDA approval in 2012, and it is unknown whether information about PrEP is reaching BMSM. Four hundred and thirty-six BMSM in Atlanta, GA were surveyed from January 2012 (6 months prior to PrEP approval) to March 2014 (20 months after approval). Analyses revealed no association between date of survey assessment and awareness of PrEP (20.5% were aware of PrEP before approval and 23.4% were aware after approval; OR = 0.99 [0.98-1.02], p = 0.952). In a multivariate model, BMSM unaware of PrEP reported lower rates of HIV testing knowledge, fewer experiences with HIV testing, and higher rates of transactional sex than BMSM who were aware of PrEP. Our findings suggest that there is limited understanding of PrEP and that there is considerable groundwork that needs to be achieved in order to reap the full benefits of PrEP. The current findings call attention to the need to both prioritize and better understand how to strengthen the bridge between medical advances and community uptake.

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Section: Prep Awareness Among Bmsm 427mentioning

confidence: 99%

Minimal Awareness and Stalled Uptake of Pre-Exposure Prophylaxis (PrEP) Among at Risk, HIV-Negative, Black Men Who Have Sex with Men

Eaton

Driffin

Bauermeister

et al. 2015

AIDS Patient Care and STDs

230

168

View full text Add to dashboard Cite

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“…The use of biomedical technologies in preventing the spread of HIV will fail if those in need are not connected to care that can facilitate access to and monitor the use of these technologies. (5, 6) Within the current HIV prevention and treatment health care landscape, it is well understood that those who are without successful engagement in care suffer worse morbidities and greater mortality than those in care and that rates of engagement in care are limited for many at elevated risk for disease. (7) Even brief lapses in care increase morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

The Role of Stigma and Medical Mistrust in the Routine Health Care Engagement of Black Men Who Have Sex With Men

et al. 2015

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Background Although HIV infections are documented among all race and sexual risk groups, black men who have sex with men (BMSM) are the most affected by HIV in the US. Currently, there is considerable emphasis on the implementation and use of biomedical HIV prevention to slow the HIV epidemic among this group; however, use of biomedical prevention requires engagement in routine medical care – a necessity that has not been met. Methods In order to better understand this shortcoming, we surveyed 544 BMSM (in 2012) to assess how health care related stigma, global medical mistrust, and personal trust in health care provider relate to engaging in medical care. We used generalized linear modeling and mediation analyses to assess data (completed in 2013). Results Twenty nine percent of participants reported experiencing race/sexual orientation stigma from heath care providers and 48% reported feelings of mistrust towards medical establishments. In generalized linear modeling we found that, among HIV negative BMSM, those who experienced greater stigma and global medical mistrust had longer gaps in time since last medical exam. Furthermore, global medical mistrust mediated the relationship between stigma and engagement in care. Among HIV positive BMSM, experiencing stigma from health care providers was also associated with longer gaps in time since last HIV care appointment. Conclusions Interventions that support the development of greater awareness around the sexual health needs of BMSM are desperately needed. Failure to address psychosocial deterrents will stymie progress made in biomedical prevention and, ultimately, cripple our ability to implement these technologies.

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“…Research has found that HIV‐positive black MSM are more likely to be unaware of their infection compared to white MSM , and less likely to initiate treatment for HIV and achieve HIV viral suppression (VS) , which dramatically reduces HIV transmissibility . Black MSM are more likely than other racial and ethnic groups to report sexual partnerships with other black men; given the existing high prevalence of untreated HIV infection among black MSM, they are thus more likely than other racial and ethnic groups to be exposed to HIV through sex . Identifying black MSM and TGW with undiagnosed HIV infection and initiating treatment for them is essential to good health outcomes ; it is also a central focus of the US strategy to control HIV and eliminate the persistent HIV disparities impacting black MSM and TGW in the US .…”

Section: Introductionmentioning

confidence: 99%

Multiple strategies to identify HIV‐positive black men who have sex with men and transgender women in New York City: a cross‐sectional analysis of recruitment results

et al. 2018

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IntroductionBlack men who have sex with men and transgender women are at high risk for HIV infection, but are more likely to be unaware of their infection or not in care for diagnosed HIV compared to other races. Respondent driven sampling has been advanced as a method to reach stigmatized and hidden populations for HIV testing. We compared strategies to recruit black, substance‐using men who have sex with men and transgender women to identify newly diagnosed HIV infection, or those previously diagnosed but not in care.MethodsThe STAR (Seek, Test, and Retain) study (ClinicalTrials.gov NCT01790360) used several recruitment strategies to identify black, substance‐using men who have sex with men and transgender women with undiagnosed HIV infection or with previously diagnosed HIV infection but who were not in HIV care. Respondent‐driven sampling, community‐based recruitment and online advertising were used to recruit participants. Incentivized peer referral was integrated into all recruitment strategies. Participants completed interviewer‐administered questionnaires and HIV testing. Demographic and HIV risk‐related characteristics and recruitment strategy were summarized and stratified by HIV status. Associations were tested using Pearson's chi‐squared, Fisher's exact, and Wilcoxon rank sum tests. Factors associated with HIV‐positive diagnosis at p < 0.1 were included in a multivariable logistic regression model.ResultsFrom July 2012 through October 2015, the study enrolled 1929 participants; 96.3% men who have sex with men and 3.7% transgender women. Behavioural risk factors included recent condomless anal sex (55.6%) and recent substance use during sex (73.1%). HIV prevalence was 8.7%. In multivariable analysis, significant associations with HIV infection included being transgender; non‐Hispanic black; gay/homosexual orientation; not homeless; and less likely to have insufficient income for necessities. Among recruitment strategies, respondent driven sampling was least effective in identifying HIV‐positive participants.ConclusionsIntegrating multiple recruitment strategies yielded a large sample of black men who have sex with men and transgender women at substantial risk for HIV. Respondent‐driven sampling was less effective than other strategies at identifying men who have sex with men and transgender women with HIV.

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Unmet HIV Service Needs Among Black Men Who Have Sex with Men in the United States

Cited by 22 publications

References 10 publications

Minimal Awareness and Stalled Uptake of Pre-Exposure Prophylaxis (PrEP) Among at Risk, HIV-Negative, Black Men Who Have Sex with Men

Minimal Awareness and Stalled Uptake of Pre-Exposure Prophylaxis (PrEP) Among at Risk, HIV-Negative, Black Men Who Have Sex with Men

The Role of Stigma and Medical Mistrust in the Routine Health Care Engagement of Black Men Who Have Sex With Men

Multiple strategies to identify HIV‐positive black men who have sex with men and transgender women in New York City: a cross‐sectional analysis of recruitment results

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