Associations Between Psychosocial Factors and Pre-exposure Prophylaxis (PrEP) Adherence Among Black Men Who Have Sex with Men in Ending the HIV Epidemic Jurisdictions: Findings from Project Adhere.

Black men who have sex with men (MSM) continue to experience disparate rates of HIV infection compared to other MSM despite advances in HIV prevention tools. Oral pre-exposure prophylaxis (PrEP) is an effective method of reducing risk of acquiring HIV when taken as prescribed, yet studies suggest Black MSM are less likely to adhere and persist on oral PrEP compared to other MSM. Existing research suggests psychosocial and structural factors impede the ability of Black MSM to adhere and persist on PrEP. As such, Project Adhere sought to better understand the relationship between psychosocial and structural factors, PrEP adherence, and persistence. Project Adhere was an observational study of 69 Black MSM in Ending the HIV Epidemic jurisdictions, tracking participants' PrEP use and various psychosocial and structural factors for six months. The study found substance use was significantly associated with lower PrEP adherence. These findings suggest a need for interventions that assess and assist Black MSM with substance use to improve PrEP adherence and persistence. Additionally, further research is needed to determine the impacts of psychosocial and structural factors on PrEP adherence and persistence in this population.