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Sexual Risk Profiles Among Black Sexual Minority Men: Implications for Targeted PrEP Messaging

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Abstract

Black gay, bisexual, and other Black sexual minority men (BSMM) continue to experience some of the largest sexual health disparities in the U.S. Engaging BSMM in PrEP is crucial to improving sexual health outcomes and reducing disparities. However, knowledge of the profiles of sexual risk and PrEP initiation among this group is limited. This study used latent class analysis to identify HIV risk and PrEP initiation patterns among BSMM in the HPTN 073 Study (n = 226). Guided by current Centers for Disease Control screening guidelines, latent class indicators included relationship status, condom use, number of sexual partners, substance use, sexually transmitted infection (STI) history, and partner HIV status. Age and PrEP initiation were used in a multinomial regression to identify correlates of class membership. Three latent classes were identified: Single, Condomless Partners, Single, Multiple Partners, and Serodiscordant Partners. Single, Condomless Partners had the highest conditional probabilities of having greater than three male partners, substance use before sex, and receiving an STI diagnosis. Serodiscordant Partners had a 100% conditional probability of condomless sex and having a male partner living with HIV. BSMM who initiated PrEP were less likely to be classified as Single, Condomless Partners than Serodiscordant Partners (AOR = 0.07, 95% CI = 0.02, 0.66). Findings support the need for culturally relevant tailored and targeted messaging for BSMM with multiple sexual risk indicators.

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Funding

Overall support for the HPTN and the HPTN Scholars Program is provided by the National Institute of Allergy and Infectious Diseases (NIAID), National Institute on Drug Abuse (NIDA), and the National Institute of Mental Health (NIMH) under Award Number UM1AI068619. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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Correspondence to Derek T. Dangerfield II.

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The authors report no conflicts of interests.

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The HPTN 073 Study protocol was reviewed and approved by Institutional Review Boards of University of California at Los Angeles, The University of North Carolina at Chapel Hill, and George Washington University. All study participants provided written informed consent, and study procedures for the present analysis were approved by the Johns Hopkins School of Medicine Institutional Review Board.

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Dangerfield, D.T., Kuo, I., Magnus, M. et al. Sexual Risk Profiles Among Black Sexual Minority Men: Implications for Targeted PrEP Messaging. Arch Sex Behav 50, 2947–2954 (2021). https://doi.org/10.1007/s10508-021-02066-w

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  • DOI: https://doi.org/10.1007/s10508-021-02066-w

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