Study Shows Promise in Reducing HIV Infections among Black Men in the U.S.
Courtesy U.S. Dept. of Health and Human Services/AIDS.gov
ALBANY, N.Y. (March 3, 2016) -- Black men who have sex with other men – historically a marginally engaged group in HIV treatment and prevention programs – are accepting and using pre-exposure prophylaxis (PrEP) to avoid becoming infected with the virus according to findings reported at the annual Conference on Retroviruses and Opportunistic Infections.
The study, led by University at Albany School of Social Welfare Dean Darrell Wheeler, found that men who reported accepting PrEP were substantially less likely to become infected with HIV.
Wheeler and his colleagues recruited 226 black men who have sex with men, and of these men 178 accepted PrEP. In that group, five new HIV infections occurred, an incidence rate of 2.9 percent, while there were three new infections among the 39 men in the study who did not accept PrEP, an incidence rate of 7.7 percent.
"This was an amazing achievement," said Sharon Hillier, Ph.D., of the University of Pittsburgh, who moderated a press conference where the study was discussed. Hillier pointed out that while PrEP is widely used by white men in their 30s, it is routinely underutilized by minority populations. “I really think that Dr. Wheeler's study is a victory in that it shows you can engage the populations who we really need to reach."
The researchers recruited black men who have sex with men in District of Columbia, Los Angeles, and Chapel Hill, N.C. After a screening to confirm an HIV-negative status, clinicians offered black men who have sex with men participation in a program called client-centered care coordination, or C4, as well as PrEP to self-administer daily in pill form.
At midpoint in the 12-month pilot study, approximately 70 percent of participants who first accepted PrEP had protective levels of the drug in their plasma. At the close of the study, 67 percent of participants reported that they were continuing to adhere to the daily regimen.
This research builds upon a 2012 study that found a disproportionately high incidence of HIV among gay and bisexual black men and supported the need for prevention programs specifically tailored to this at-risk population.
That same 2012 study found black men who have sex with men are likely to face psychological and social problems and encounter barriers to accessing care. The C4 intervention was designed to address some of these issues to increase the likelihood that participants would adhere to PrEP. In voluntary C4 sessions, a team of healthcare professionals provided counseling, care and referrals for client-identified problems, including substance use, homelessness, mental health and medical issues, and intimate partner violence.
"While not all the participants in the study accepted PrEP, we were able to retain more than 90 percent of the group in the study," Wheeler said. He noted that engaging black men who have sex with men into the studies has been challenging, and that this study may have been more effective in recruitment because it is the first network trial designed for and implemented by African Americans.
According to the Centers for Disease Control and Prevention, black man who has sex with men in the United States have a roughly one in two likelihood that they will become HIV-positive in their lifetime. "This study really showed that with the right approach you can connect into the black men who have sex with men in the community and you can get good uptake," said Hillier.
The next goal for the researchers is to expand the numbers of participants to be more representative of black men who have sex with men across the U.S.
The study was conducted by the HIV Prevention Trials Network and funded by the National Institute of Allergy and Infectious Diseases (NIAID) and the National Institute on Drug Abuse, parts of the National Institutes of Health.
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