title: Enhancing PrEP Access for Black and Latino Men Who Have Sex With Men.
abstract: OBJECTIVE
  Implementation of HIV pre-exposure prophylaxis (PrEP) programs for populations with highest incidence is critical to reducing new infections in the United States. Black and Latino men who have sex with men (BLMSM) are disproportionately burdened by HIV. We examined differences in perceived barriers and facilitators to PrEP access for BLMSM compared with other men who have sex with men (MSM).
  
  
  METHODS
  MSM who met the Centers for Disease Control and Prevention criteria for PrEP (n = 491) completed measures of barriers and facilitators to PrEP at the systems, provider, and individual levels. Multivariate analyses examined differences by race/ethnicity, adjusting for other sociodemographic factors.
  
  
  RESULTS
  Compared with other MSM, BLMSM (56% of the sample) were more likely to have public insurance and to access health care via public clinics [adjusted odds ratio(aOR) 3.2, P < 0.001; aOR 2.4, P < 0.01]. BLMSM were more likely to regard having to talk to their doctor about their sex life as a barrier to PrEP (aOR 3.7, P < 0.001) and were less likely to endorse agency in medical decision making (aOR 0.58, P < 0.001). BLMSM were more likely to report PrEP stigma (aOR 2.3, P < 0.001) and concerns regarding PrEP efficacy (aOR 1.6, P < 0.05). BLMSM were more likely to consider access to free sexual health care (aOR 2.1, P < 0.01) and additional supportive services, eg, counseling (aOR 3.1, P < 0.001) or text-based support (aOR 2.9, P < 0.001) to be significant facilitators of PrEP use.
  
  
  CONCLUSIONS
  Findings suggest specific points of multilevel intervention to increase PrEP access for BLMSM and increase representation of BLMSM along the PrEP continuum of care.
authors.affiliation: *Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY; and †Department of Psychology, Basic and Applied Social Psychology PhD Program, The Graduate Center of the City University of New York (CUNY), New York, NY.
authors.forename: Corina
authors.initials: C
authors.lastname: Lelutiu-Weinberger
authors.forename: Sarit A
authors.initials: SA
authors.lastname: Golub
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D044383:Black People; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000517:prevention & control*; D006297:Health Services Accessibility; D006630:Hispanic or Latino; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D065129:Pre-Exposure Prophylaxis / Q000706:statistics & numerical data*; D014481:United States; D055815:Young Adult; D001741:Black or African American
chemical_list: D044966:Anti-Retroviral Agents