Building effective multilevel HIV prevention partnerships with Black men who have sex with men: experience from HPTN 073, a pre‐exposure prophylaxis study in three US cities

作者：Darrell P. Wheeler, Jonathan Lucas, Leo Wilton, LaRon E. Nelson, Christopher Hucks‐Ortiz, Christopher Chauncey Watson, Craig S Hutchinson, Kenneth H. Mayer, Irene Kuo, Manya Magnus, Geetha Beauchamp, Steven Shoptaw, Lynda Emel, Ying Qing Chen, Lisa Hightow‐Weidman, Sheldon D. Fields · 发表于：Journal of the International AIDS Society · 年份：2018 · DOI：10.1002/jia2.25180 · 被引用次数：24 · 研究领域：HIV/AIDS Research and Interventions、HIV, Drug Use, Sexual Risk、HIV Research and Treatment

The sub-population at greatest risk for HIV infection in the United States is Black men who have sex with men (BMSM), and there is an urgent need for effective HIV prevention interventions among them 1. Despite advances in biomedical and behavioural interventions, healthcare systems continue to fail to slow the epidemic among BMSM. This is particularly the case among young men 2, who have an estimated lifetime risk of HIV infection of up to 50% 3. It has been well demonstrated that tenfovir disiproxil fumarate (TDF) and emtricitabine (FTC) as pre-exposure prophylaxis (PrEP) are effective in protecting those at risk of HIV acquisition from sex or injection drug 4, 5, but prescriptions to BMSM have sorely lagged behind other affected populations, including gay and bisexual White men 5, 6. Myriad structural characteristics, including poor health, poverty, stigma, high rates of incarceration, inadequate housing, lack of health insurance, decreased educational attainment and unemployment, impede recruitment and retention of BMSM in studies 6, 7. This constellation of factors is likely responsible for both high HIV prevalence and low uptake of PrEP (and other interventions) 8. Clearly, effective interventions to increase PrEP uptake among BMSM are urgently needed; yet, in public health and medicine, we continue to miss the mark 5. Just one demonstration project cannot overcome this full range of barriers. However, in the HIV Prevention Trials Network (HPTN) 073 study discussed in t...