# Longitudinal Predictors of PrEP Use and Adherence Among Young Black MSM

> **NIH NIH R01** · MEDICAL COLLEGE OF WISCONSIN · 2020 · $366,779

## Abstract

Pre-exposure prophylaxis (PrEP) dramatically reduces the risk of HIV infection, especially for those
who are most adherent. However, for PrEP to significantly impact the HIV epidemic, those most at risk of HIV
must both use and adhere to PrEP. Data suggest that a substantial proportion of men who have sex with men
(MSM) stop using PrEP soon after starting; they may or may not resume use. There is also evidence that many
young men may not consistently adhere to PrEP. However, we know very little about the frequency of PrEP
termination, gaps in PrEP use, or lapses in prevention-effective adherence among young Black MSM
(YBMSM), or about short- and long-term changes in use and adherence for these men. Additionally, we lack
information about how use and adherence among YBMSM may be impacted by structural and psychosocial
barriers to PrEP (including issues with health care access and insurance; low socioeconomic status and
instability in employment, transportation, and housing; poor mental health; substance use; and stigma and
negative social norms related to PrEP) or partner and relationship factors (such as the introduction of new
partners, the development of committed relationships, perceptions of partner risk, and intimate partner
violence). The overall aim of the proposed research is to use short- and long-term prospective, longitudinal
data from YBMSM PrEP users to examine patterns and predictors of PrEP use and adherence, with the goal of
identifying targets for PrEP interventions with this high-risk population. We will recruit 200 YBMSM (ages 18-
30) who use PrEP from Midwestern metro areas with large racial disparities in HIV (Detroit, MI; Kansas City,
MO; Milwaukee, WI; and Minneapolis, MN). Men will complete surveys assessing PrEP use and adherence
along with hypothesized predictors every 3 months for 1 year. Additionally, a subsample of 100 users will
complete 14 days of electronic daily diaries to assess micro changes in adherence, other sexual health and
risk behaviors, and key predictors. Dried blood spot tests for tenofovir will be used to objectively assess
adherence, and information on HIV and STI testing and infection will be drawn from linked medical records.
Through the application of modern analytic methods, this research will address the following aims: (1) Describe
longitudinal changes in PrEP use and adherence among YBMSM, and associations between PrEP use and
adherence and other sexual health and risk behaviors and outcomes; (2) Identify factors associated with gaps
in PrEP use, PrEP termination, and poor PrEP adherence for YBMSM over 1 year; and (3) Identify factors
associated with PrEP adherence at the daily level for YBMSM using daily diary surveys. We predict that gaps
in PrEP use, PrEP termination, and lapses in prevention-effective adherence will be common, and that they will
be associated with structural and psychosocial barriers as well as sexual partner and relationship factors.
Information on how and why use and adh...

## Key facts

- **NIH application ID:** 9900873
- **Project number:** 5R01MH115764-03
- **Recipient organization:** MEDICAL COLLEGE OF WISCONSIN
- **Principal Investigator:** Jennifer Lynn Walsh
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $366,779
- **Award type:** 5
- **Project period:** 2018-04-01 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9900873

## Citation

> US National Institutes of Health, RePORTER application 9900873, Longitudinal Predictors of PrEP Use and Adherence Among Young Black MSM (5R01MH115764-03). Retrieved via AI Analytics 2026-06-07 from https://api.ai-analytics.org/grant/nih/9900873. Licensed CC0.

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