PrEP Willingness Associated With Arrest History Among Black Americans

A team of investigators deployed a survey to assess willingness to use PrEP among a cohort of Black individuals with a history of arrest.

Differential willingness to take pre-exposure prophylaxis (PrEP) for HIV among a cohort of Black Americans was found to be associated with whether or not the individuals had a history of arrest, according to the findings of a survey published in the Journal of Racial and Ethnic Health Disparities.

Researchers from Harvard University analyzed data from the 2016 National Survey on HIV in the Black Community conducted in the United States. Participants (N=868) were assessed for sociodemographic characteristics, sexual risk, and willingness to take PrEP.

Respondents had a mean age of 33.59 years (standard deviation, 9.20), 54.4% were women, 61.6% were single, 71.6% were employed, 56.3% had some college education or higher, 48.2% earned $50,000 or more annually, and 26.0% stated they were willing to take PrEP. Individuals with a history of arrest (n=226) were older (P <.0001), predominantly men (P <.0001), less likely to have a college education (P <.0001), less willing to take PrEP (P =.0008), and earned less income (P =.0144).

Individuals with and without a history of arrest stated they had engaged in anal sex (51.3% vs 29.5%; P <.0001), had a history of sexually transmitted disease (36.9% vs 24.4%; P =.0007), had been tested for HIV during the past year (36.2% vs 24.5%; P =.0009), had unprotected sex during the past 3 months (63.4% vs 56.1%; P =.0729), and had multiple partners during the past 3 months (11.6% vs 8.5%; P =.1689).

Willingness to take PrEP was associated with having had multiple partners during the past 3 months (adjusted prevalence ratio [aPR], 2.61; 95% CI, 1.77-3.85; P <.0001) among individuals with a history of arrest and for no history of arrest, among those who were single (aPR, 1.69; 95% CI, 1.13-2.53; P =.0113), and among those who reported having engaged in anal sex (aPR, 1.46; 95% CI, 1.01-2.12; P =.0429) during the past 3 months.

Although this study was nationally represented, it was limited to those who had internet access and as such did not include vulnerable populations such as those who were currently incarcerated, homeless, or transiently housed.

The study authors concluded that risky behaviors and willingness to take PrEP varied among Black individuals on the basis of arrest history.


Uzoeghelu U, Bogart LM, Mahoney T, Ghebremichael MS, Kerr J, Ojikutu BO. HIV risk-related behaviors and willingness to use pre-exposure prophylaxis among Black Americans with an arrest history. J Racial Ethn Health Disparities. Published online February 5, 2021. doi:10.1007/s40615-021-00980-2