PROJECT SUMMARY
Background. The social networks of Black men, including Black gay, bisexual and other Black sexual
minority men (SMM), influence their decision-making and HIV-related behaviors (e.g., condom use, HIV
testing). Social networking strategies (SNS) interventions have been successful at increasing HIV testing
among Black SMM who had never been tested and with unknown HIV status in Washington, D.C. (McCree et
al., 2013; Baytop et al., 2014). A recent differential effectiveness study among Black SMM in Washington, DC
(conducted at Us Helping Us) demonstrated SNS to be superior to venue testing and partner services in
recruiting men that had never been tested (Baytop et al., 2014). SNS interventions also circumvent structural
barriers to pre-exposure prophylaxis (PrEP) such as stigma, discrimination and medical mistrust. The proposed
study aims are to design and open-phase pilot a low-intensity, cost-effective SNS intervention to increase PrEP
initiation among Black SMM. This is critical because Black SMM have the highest HIV incidence in the U.S.
and based on current HIV prevention, treatment and care rates, 50% of Black SMM will acquire HIV in their
lifetime compared with ~10% of White SMM and 25% of Latino SMM Importantly, this highlights a critical
failure of the U.S. public health system. Therefore, focused HIV prevention and social network-based
intervention efforts, such as SNS, are warranted to meet the unique needs of Black SMM.
Overview of project. The first 12 months (Phase 1: Formative Research) will be an intervention
development/adaptation phase. Using a community-based participatory approach (n=18 age- and PrEP use
profile-specific focus groups, of at least 4-5 participants each, totaling 72-90), participants will be asked about
the social network dynamics and characteristics (e.g., influential network members, communication about PrEP
as an HIV prevention method) that influenced their decision to initiate PrEP. Among participants with no PrEP
use, they will be asked about the acceptability and feasibility of talking with PrEP-using Black SMM within their
respective social network to support initiation along with preferences for relevant PrEP-related information from
peers. The following 12 months (Phase 2: Open-phase Pilot Study) will involve conducting an open pilot of the
SNS intervention, in up to six batches of up to 5 participants (n=30), allowing for further intervention
refinement. This will allow us to demonstrate participant feasibility and acceptance, which includes the ability to
recruit network members, feasibility of intervention delivery, and changes in participant behaviors. It will allow
for further evaluation of the feasibility of all study procedures, refinement of intervention manual, and provide
pilot data to submit an NIH application for a larger prospective trial. Therefore, the expected outcome is a
culturally relevant SNS intervention to increase PrEP initiation among Black SMM through PrEP-using social
network members.