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Abstract
In the United States, Black heterosexual men face a disproportionately high risk of HIV, surpassing rates observed in other racial and ethnic groups. This vulnerability is rooted in various socio-economic challenges, including residing in areas marked by low economic conditions, heightened income inequality, and imbalanced male-to-female ratios due to high rates of male incarceration. Limited access to HIV prevention services further compounds this issue.This research focuses on the awareness and likelihood of using pre-exposure prophylaxis (PrEP) among 568 heterosexual Black men, revealing a significant knowledge gap. Despite PrEP's proven efficacy in preventing HIV transmission, 65% of participants were unaware of its existence. Even after being informed, 72% expressed reluctance to adopt PrEP within the next 90 days, underscoring the urgent need for targeted educational initiatives within this community.
The study identified sociodemographic factors, key determinants influencing PrEP awareness, and intention to use. Age, ethnicity, partnership status, higher household income, and employment status emerged as significant contributors to PrEP awareness. Unexpectedly, higher self-efficacy negatively correlated with PrEP utilization, challenging widespread beliefs. Psychosocial factors like depression were unexpectedly linked to increased odds of PrEP use, contrary to the belief that mental health challenges act as barriers. Positive associations were found between elevated perceived susceptibility, depression, and increased PrEP use. Conversely, factors like perceived stigma-related barriers, history of incarceration, and substance use did not significantly impact PrEP utilization.
Comparing these findings with existing literature reveals persistent challenges hindering PrEP uptake among heterosexual Black men. Sociodemographic factors such as age, ethnicity, marital status, education, employment, income, housing, and healthcare coverage play critical roles in PrEP decision-making, confirming disparities highlighted in prior research. This study introduces unexpected outcomes that challenge conventional beliefs about mental health and self-efficacy as barriers to PrEP adoption, contributing to a nuanced understanding of factors influencing PrEP decisions among heterosexual Black men and informing more effective and targeted interventions within this community.