I Am Men’s Health

Abstract

In 2012, the US Food and Drug Administration approved Truvada as a pre-exposure prophylaxis (PrEP) for adults at risk of HIV. PrEP is highly effective at preventing HIV when taken daily, but no gold standard exists for consistently administering PrEP to populations at highest risk. The "I Am Men's Health" program used an innovative methodology to generate adherence to PrEP in 23 mostly young men who have sex with men of color (yMSMc), during a 28-week period from February to September 2013. Adherence was measured using weekly medication pickup rates. The average age of the participants was 21 years, and the majority were black and lived below the poverty line. Time on PrEP ranged from 1 to 28 weeks (2723 person-days), and the weighted average adherence was 73%. The methodology used in this study was preliminarily effective at generating adherence to PrEP among high-risk yMSMc in a community setting and may help inform large-scale future HIV prevention interventions.

A systematic review of adherence to oral pre-exposure prophylaxis for HIV – how can we improve uptake and adherence?

“…The prospect of social ostracism and prosecution introduces further structural barriers to accessing healthcare services, reducing PrEP uptake and adherence. In a study of young MSM of colour in the USA, 39% had been kicked out of their home due to their sexual orientation and 43% had spent at least one night on the street [ 50 ]. These factors, combined with the prevalence of transactional sex, mean that young women and MSM, particularly transgender women, are often subject to abuse [ 5 , 50 ] and frequently lack decision-making power over their bodies when it comes to sexual encounters [ 51 ].…”

Challenges in Translating PrEP Interest Into Uptake in an Observational Study of Young Black MSM

“…Previous PrEP demonstration projects and clinical trials that have included PrEP utilized a full clinical staff including clinicians, lab technicians, social workers, and counselors devoted to PrEP education, initiation, and retention [12, 13, 21–23]. Several projects offered regular clinical hours allowing for “drop in” visits and also provided additional support services including counseling, meal/housing assistance, and leadership/job training courses [12, 21]. Notably, a few studies were incentivized and recruited individuals already interested in taking PrEP [13, 21, 23].…”

“…Prior studies have relied on external referrals for PrEP outside of the research study context [9]. A referral-based program may not fully address these barriers for YBMSM as many lack access to healthcare [8, 12–14]. Here, we describe the implementation of an optional PrEP program as an addition to a standard package of HIV prevention services in a currently enrolling, HIV/STI incidence cohort of YBMSM in Atlanta, GA. A detailed understanding of facilitators and barriers to PrEP uptake among YBMSM is necessary to inform the development of targeted interventions to promote PrEP uptake and adherence within this population.…”

Equality in sexual health promotion: a systematic review of effective interventions for black and minority ethnic men who have sex with men

“…We have also identified six intervention development studies (Table 2 ) [ 40 – 45 ], of which I am men’s health [ 40 ] is the only study where PrEP adherence formed the outcome measure. In this study, an overall compliance rate of 73 % among young black MSM was found.…”

“…This is consistent with the prominence of internet, mobile and application communication within young MSM communities with regard to gay in-group socialising, and sexual partner seeking [ 54 ]. Finally, we identified one study [ 40 ] that discussed adherence to pre-exposure prophylaxis (PrEP) in young MSM of colour. This is important in view of the promising findings from recent clinical trials that PrEP constitutes an effective barrier against HIV infection among MSM [ 55 ].…”