# Increasing PrEP Use in High-Risk Social Networks of African American MSM in Underserved Low-Uptake Cities

> **NIH NIH R01** · MEDICAL COLLEGE OF WISCONSIN · 2020 · $670,046

## Abstract

Abstract
 PrEP is a powerful and potentially groundbreaking HIV prevention strategy, but its public health impact
will depend on widescale adoption by persons at greatest risk for contracting HIV infection. PrEP awareness
and use remain especially low among African American MSM in mid-sized cities across the center of the
country, and very little research has tested interventions that can increase PrEP awareness, benefit
perception, and normative support—and decrease PrEP stigma and concerns—among African American MSM
in these cities. PrEP can achieve its full public health potential only when its uptake among racial minority
MSM in neglected mid-sized American cities is increased. In prior research, our team established that
network-level interventions can reach and be used to deliver effective HIV risk reduction interventions to Black
MSM in the industrial Midwest, including hard-to-reach men hidden in the community. The planned mixed-
methods research will now evaluate a network intervention to increase PrEP uptake among high-risk African
American MSM in Milwaukee and Cleveland, cities where HIV racial disparities are profound but PrEP use is
low. In a formative research phase, in-depth interviews will be conducted with African American MSM, PrEP
providers, and other key informants in each city to identify understandings, concerns, barriers, and facilitators
of PrEP use. In the main intervention trial phase, 36 social networks of high-risk racial minority MSM
(expected n=504 participants) will be enrolled, 18 networks per city, by recruiting high-risk initial “seeds,”
members of each seed's MSM friendship network, and then two outward successive rings of their friends. All
study participants will receive baseline counseling for PrEP and risk reduction. The 36 networks will then be
randomized in equal numbers to intervention and comparison conditions. In each intervention condition
network, a cadre of network leaders open to PrEP, trusted for advice, and highly interconnected with others will
attend an intervention that educates and then provides training and guidance in diffusing messages to friends
to encourage PrEP uptake, correcting PrEP misconceptions and stigma, and instilling positive PrEP norms and
benefit perceptions. At baseline and 6- and 15-month followup points, participants will complete measures of
PrEP use corroborated by the testing of dried blood spot specimens for tenofovir; measures of PrEP related
knowledge, attitudes, perceived norms, and stage of change readiness; sexual risk practices; and substance
use. We hypothesize that the network intervention will produce greater PrEP adoption by HIV- participants
than that found in comparison networks. PrEP knowledge, attitudes, intentions, peer norms, and stage of
change readiness will be explored as both mediators and as secondary outcomes. Intervention effects on HIV
incidence will be mathematically modeled to determine its public health impact. This research will test a novel
...

## Key facts

- **NIH application ID:** 9962497
- **Project number:** 5R01NR017574-04
- **Recipient organization:** MEDICAL COLLEGE OF WISCONSIN
- **Principal Investigator:** Yuri A Amirkhanian
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $670,046
- **Award type:** 5
- **Project period:** 2017-09-21 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9962497

## Citation

> US National Institutes of Health, RePORTER application 9962497, Increasing PrEP Use in High-Risk Social Networks of African American MSM in Underserved Low-Uptake Cities (5R01NR017574-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9962497. Licensed CC0.

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