Abstract
Young Latino men who have sex with men (MSM) are a highly vulnerable population for HIV infection. Pre-exposure prophylaxis (PrEP) is a novel biomedical HIV prevention tool that may aid in reducing the disparity in HIV incidence among Latino MSM. However, PrEP use is disproportionally low among Latino MSM and, therefore, identifying barriers along the PrEP continuum of care (the “PrEP cascade”) would provide insight into how to best deploy PrEP interventions. Syndemics theory is a prominent framework employed in HIV prevention; however, to date, no known studies have applied this theory to PrEP. Thus, the aim of the current study was to explore the association between syndemics and the PrEP cascade, including the degree to which psychosocial and structural syndemic constructs are related to the PrEP cascade. Participants were 151 young Latino MSM (M age = 24 years; SD = 3) residing in San Diego, California, who completed a battery of online self-report measures. Results indicated high levels of syndemic indicators and varying levels of engagement across the PrEP cascade. As syndemic indicators increased, the odds of engagement across the PrEP cascade were significantly lowered. Psychosocial and structural syndemic factors accounted for unique variance in the PrEP cascade. Results highlight the need for combination interventions that address both psychosocial and structural barriers to PrEP use and persistence among young Latino MSM.
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Research reported in this publication was supported by the Department of Psychology at San Diego State University. Additionally, some of the author time was funded by K23MH096647 (Blashill) and 9K24DA040489 (Safren). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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Blashill, A.J., Brady, J.P., Rooney, B.M. et al. Syndemics and the PrEP Cascade: Results from a Sample of Young Latino Men Who Have Sex with Men. Arch Sex Behav 49, 125–135 (2020). https://doi.org/10.1007/s10508-019-01470-7
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DOI: https://doi.org/10.1007/s10508-019-01470-7