Examining the impact of race/ ethnicity in PrEP care without considering structural racism and dis – crimination may miss certain factors that impact care, according to results published in AIDS and Behavior. Florence Momplaisir, MD, MSHP, and colleagues conducted a systematic literature review of 66 studies. At the interpersonal level, individuals with medical mistrust were less likely to know about PrEP, adhere to PrEP, and remain in care. At the intra-organizational level, PrEP uptake was lower for Black patients due to clinicians’ perception of higher sex-risk behaviors. At the extra-organizational level, factors including homelessness, low socioeconomic status, and incarceration were associated with reduced PrEP uptake. Conversely, clinician trust, higher patient education, and health insurance were associated with higher PrEP use and retention in care. Analyses using race/ethnicity as an exposure did not consistently show associations with PrEP continuum outcomes. “Addressing multi-level barriers related to [structural racism and discrimination] are needed to reduce HIV transmission and promote health equity,” Dr. Momplaisir and colleagues wrote.
