Behavioral Interventions to Enhance PrEP Uptake Among Black Men Who Have Sex With Men: A Review.

Only seven behavioral intervention studies were included, and only a few focused exclusively on Black MSM. Studies were included if any part of the sample was Black MSM, so the results may not apply specifically to Black MSM. The only study that showed a sustained increase in adherence had a mostly White sample, with only 14% Black MSM. Only two studies used a randomized controlled design, and only two studies described a theoretical framework. Postintervention follow-up was generally brief, with the longest follow-up 12 months after the final study visit. All seven studies used self-reported adherence measures, and self-reported adherence was consistently higher than drug plasma levels. The studies were conducted in large urban settings across the United States, so they may not apply to rural or non-US settings. Black MSM are a hard-to-reach population, and reliance on convenience or purposive sampling can increase risk of bias.

Do not conclude that these behavioral interventions improve PrEP adherence in Black MSM. Only one included study showed a sustained increase, and that sample was mostly White, with only 14% Black MSM; medication adherence declined in the other six studies.