Black gay, bisexual and other men who have sex with men (MSM) face a disproportionate burden of HIV.
Focused, high-coverage PrEP in populations heavily impacted by HIV, such as Black MSM, could rapidly
reduce new HIV acquisition rates; however, its uptake among at-risk populations, especially Black MSM, has
been limited. Therefore, we propose to conduct urgently needed research on PrEP in a cohort of Black MSM,
including on the impact of relevant behaviors, particularly cannabis use, which is highly prevalent in Black
MSM. Research on the impact of cannabis use on PrEP has achieved conflicting results, and it has not been
rigorously studied in Black MSM. Therefore, the proposed R01 study will assess cross-sectional and
longitudinal associations between cannabis use and PrEP outcomes (e.g., use, adherence) and HIV
transmission risk (e.g. biological inflammation, sexual risk behavior) using event-level and objective biomarker
data among HIV-negative Black SMM. To address these specific aims, we will conduct the Networks and
Neighborhoods (N2) Cannabis PrEP Study in Chicago, IL. We will follow 250 HIV-negative participants from
the original N2 cohort for an additional one-year period with 3 study waves. We will use innovative and rigorous
methods, to collect additional data, such as Ecological Momentary Assessment methods and objective
measures of cannabis use, PrEP use, and immune function over 14-day periods at each wave. Potential
findings can impact intervention development and implementation, as well as inform policy to increase PrEP
uptake and adherence, address substance use, and decrease HIV transmission rates, and disparities.