The Role of Social Support in HIV Testing and PrEP Awareness among Young Black Men and Transgender Women Who Have Sex with Men or Transgender Women

Corina Lelutiu-Weinberger, Leo Wilton, Beryl A. Koblin, Donald R. Hoover, Sabina Hirshfield, Mary Ann Chiasson, Vijay Nandi, Da Shawn Usher, Victoria Frye

Research output: Contribution to journalArticlepeer-review

29 Citations (Scopus)

Abstract

Young black men and transgender women (transwomen) who have sex with men or transwomen are most vulnerable in terms of risk for HIV infection, also reflected in their extremely high incidence rates. As testing rates and pre-exposure prophylaxis (PrEP) uptake remain suboptimal among these groups, primarily due to unique structural barriers, the present analyses draw on data from an online survey, administered October 2014 to August 2015, to explore social support–related predictors of knowledge and behavior around HIV prevention. Participants were 169 biological men who identified as black, with a mean age of 24 (SD = 2.97, range 17–29); 8% identified as transwomen. Logistic regression models assessed whether HIV-related social support predicted HIV testing patterns, PrEP awareness, and use. Those with higher HIV-related social support reported having been more likely to have ever tested (adjusted odds ratio (aOR) = 1.48; p < 0.001) and tested in the past 6 months (aOR = 1.22; p < 0.01). They were also more likely to intend to test in the next 6 months (aOR = 1.16; p < 0.001), including at a medical office or community-based organization (aOR = 1.20; p < 0.001), yet less likely to intend to self-test (aOR = 0.81; p < 0.001). Lastly, higher social support was significantly associated with prior knowledge of self-testing (aOR = 1.19; p < 0.05), couples testing (aOR = 1.26; p < 0.001), and PrEP (aOR = 1.22; p < 0.01), as well as prevention self-efficacy (aOR = 1.30; p < 0.001), but inversely associated with prior self-testing (aOR = 0.80; p < 0.05). For young black men and transwomen who have sex with men or transwomen, HIV-related social support, which likely has a strong peer component, appears to be a facilitator of optimal testing and intentions to test, as well as awareness of novel prevention strategies (like self-testing or PrEP). However, community resourcefulness needs to be bolstered by other mechanisms, such as changes within healthcare settings, to increase actual use of novel prevention modalities.

Original languageEnglish
Pages (from-to)715-727
Number of pages13
JournalJournal of Urban Health
Volume97
Issue number5
DOIs
Publication statusPublished - 1 Oct 2020
Externally publishedYes

Keywords

  • Black individuals
  • HIV testing
  • HIV-prevention
  • Men who have sex with men
  • Peer support
  • Pre-exposure prophylaxis
  • Transgender women

ASJC Scopus subject areas

  • Health (social science)
  • Urban Studies
  • Public Health, Environmental and Occupational Health

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