Date of Award

Fall 2021

Document Type

Open Access Dissertation


Health Promotion, Education and Behavior

First Advisor

Xiaoming Li


INTRODUCTION: Pre-exposure prophylaxis (PrEP) is a pill, taken orally, that has been shown to be effective at reducing the chance that someone who is HIV-negative and at-risk for HIV will contract the disease during sexual intercourse with someone who is living with HIV. One demographic group that has been under-researched is Black heterosexual men. This dissertation presents research on evaluating the heterosexual Black men’s awareness of, prior use, and network of friends/family’s perceived interest in learning more about PrEP.

METHODS: Two-hundred and six Black heterosexual men living in Brooklyn, New York City, were surveyed about their sexual behaviors and PrEP use and interest at their local barbershop in 2016. Another 505 Black heterosexual men were surveyed about sexual behaviors and PrEP awareness of, use, and interest in Dar Es Salaam, Tanzania during the baseline phase of a controlled-randomized trial surrounding HIV self-testing in social camps in 2019.

RESULTS: In Brooklyn, 82% of men reported not having heard of PrEP and 55.3% of the 206 surveyed men reported not having used PrEP themselves or knowing someone who had. Some 45.1% of men believed that their network of friends and family would be somewhat interested in learning more about PrEP, while 28.2% believed their friends and family would be very interested. In Dar Es Salaam, 85.6% of men reported having never heard of PrEP prior to the survey. Still, 71.5% of men reported being likely to take PrEP if it were offered to them. Thirty-six percent of men reported that a reason that would make other men not want to take PrEP is not knowing where to get it from. Nearly 40% of men stated that they believed they would use PrEP before sexual intercourse either every time or every other time.

CONCLUSION: Future research should explore intervention strategies for increasing PrEP access and use for heterosexual Black men such as barbershops and social camps as venues to raise awareness and for delivering PrEP. In tandem with strategic partnerships among community-based organizations, health departments, health clinics and hospital systems, both barbershops and social camps offer unique and useful opportunities to reach heterosexual Black men and their peers.


© 2021, Akeen Lowell Hamilton