Not the Mobile Van! Antiretroviral Delivery Preferences Among Young Black Sexual Minority Men Along a Status-Neutral HIV Care Continuum

Antiretroviral (ARV) uptake among young Black sexual minority men (YBSMM) along the status-neutral continuum is lower than necessary for Getting to Zero goals to end the HIV epidemic by 2030. Multiple studies indicate that Black men are less likely to use pre-exposure prophylaxis (PrEP) and be virally suppressed. This study examined YBSMM preferences for ARV procurement.

This study utilized focus groups (N = 21 attendees) and in-depth-interviews (N = 3) from HIV-positive and HIV-negative men using ARV for treatment or prevention of HIV. Men’s interest in long-acting injectable antiretroviral therapy (LAI-ART) was also explored. Focus groups and interviews were conducted via Zoom and analyzed using the Rigorous and Accelerated Data Reduction (RADaR) technique.

Participants preferred mail delivery (42%) and pharmacy pick-up (58%) for procurement of ARV. Mobile van delivery was the least preferred option due to privacy concerns. LAI-ART piqued the interest of YBSMM, but participants required more education about this modality before they would adopt it.

YBSMM require flexible options for ARV procurement across the status-neutral HIV care continuum, including mail delivery and pharmacy pick-up. YBSMM may benefit from conversations with their providers about how they wish to obtain ARV medications. Education around LAI-ART is required for YBSMM who may benefit from this option. Furthermore, valuation of YBSMM expertise and sensitivity around privacy in care engagement is required for decreasing HIV acquisition in this population.

Involving YBSMM in decisions regarding ARV delivery systems may improve PrEP and HIV medication adherence. Medical providers, public health officials, and pharmaceutical companies should dialogue with YBSMM regarding access to medications that treat and prevent HIV. Furthermore, Ryan White HIV Programming may benefit from inclusion of YBSMM who are not living with HIV for optimal HIV treatment and prevention efforts to increase ARV procurement and adherence among key populations.