# Assessing Psychosocial Predictors of PrEP Adherence and Persistence Among Young Black MSM

> **NIH NIH R21** · UNIVERSITY OF MARYLAND BALTIMORE · 2021 · $208,182

## Abstract

Project Summary/Abstract
Young Black men who have sex with men (YBMSM) continue to experience a disproportionate rate of HIV
infections in the United States. HIV pre-exposure prophylaxis (PrEP) is a biomedical prevention intervention
shown to reduce risk of HIV infection; however, studies suggest YBMSM are less likely to be prescribed PrEP
and have significantly lower levels of adherence to PrEP compared to white MSM. PrEP use among YBMSM is
estimated at between 3%-20%. In addition to concerns with adherence, persistence on PrEP among YBMSM
is low, with discontinuation rates ranging between 17% to 22% within 6 months of starting PrEP. Psychosocial
risk and protective factors might contribute to PrEP adherence and persistence among this population.
Preliminary evidence suggests a relationship between PrEP adherence among YBMSM and psychosocial
factors. Among YBMSM, stigma and low self-perceived HIV risk were cited as the most common reasons for
PrEP refusal. However, it is not clear that these findings can be extended to adherence and persistence to
PrEP among YBMSM because of the lack of the empirical data on the life cycle of PrEP use among YBMSM.
Using a risk and resiliency framework, we will conduct a mixed methods study to understand the natural life
cycle of PrEP use among YBMSM in Atlanta. The specific aims of the study are to characterize the patterns of
PrEP adherence in the life cycle of PrEP use among YBMSM; identify and describe the psychosocial risk and
protective factors to PrEP persistence and adherence; and identify intervention targets for a future PrEP
adherence intervention. To achieve these aims, in Aim 1 we will follow 100 YBMSM newly-initiating PrEP for 6
months. Participants will complete weekly assessments of their PrEP use and sexual behavior weekly for the
first 90 days and then monthly thereafter. Quarterly, participants will also complete assessments of
psychosocial domains (depressive symptomatology, substance use, social support, perceived HIV risk).
Adherence will be captured using a self-report item and confirmed via self-collected dried blood spot (DBS)
testing at three and six months. In Aim 2, up to 40 YBMSM will complete in-depth individual interviews (IDIs)
describing their experiences using PrEP, highlighting their decisions about daily adherence and the
psychosocial risk and protective factors that contributed to their levels of adherence and persistence or
discontinuation of PrEP. Lastly, drawing upon the psychosocial risk and protective factors associated with
PrEP discontinuation and PrEP persistence in Aim 1 and the content and examples from individual interviews
in Aim 2, in Aim 3 we will identify psychosocial intervention targets associated with PrEP adherence. This study
will lay the foundation for the development of interventions to support PrEP adherence and persistence among
this population.

## Key facts

- **NIH application ID:** 10452231
- **Project number:** 7R21MH121120-02
- **Recipient organization:** UNIVERSITY OF MARYLAND BALTIMORE
- **Principal Investigator:** Jeb Jones
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $208,182
- **Award type:** 7
- **Project period:** 2021-09-01 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10452231

## Citation

> US National Institutes of Health, RePORTER application 10452231, Assessing Psychosocial Predictors of PrEP Adherence and Persistence Among Young Black MSM (7R21MH121120-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10452231. Licensed CC0.

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