PROJECT SUMMARY Black gay, bisexual and other men who have sex with men (MSM) face a disproportionate burden of HIV. Focused, high-coverage PrEP in populations heavily impacted by HIV, such as Black MSM, could rapidly reduce new HIV acquisition rates; however, its uptake among at-risk populations, especially Black MSM, has been limited. Therefore, we propose to conduct urgently needed research on PrEP in a cohort of Black MSM, including on the impact of relevant behaviors, particularly cannabis use, which is highly prevalent in Black MSM. Research on the impact of cannabis use on PrEP has achieved conflicting results, and it has not been rigorously studied in Black MSM. Therefore, the proposed R01 study will assess cross-sectional and longitudinal associations between cannabis use and PrEP outcomes (e.g., use, adherence) and HIV transmission risk (e.g. biological inflammation, sexual risk behavior) using event-level and objective biomarker data among HIV-negative Black SMM. To address these specific aims, we will conduct the Networks and Neighborhoods (N2) Cannabis PrEP Study in Chicago, IL. We will follow 250 HIV-negative participants from the original N2 cohort for an additional one-year period with 3 study waves. We will use innovative and rigorous methods, to collect additional data, such as Ecological Momentary Assessment methods and objective measures of cannabis use, PrEP use, and immune function over 14-day periods at each wave. Potential findings can impact intervention development and implementation, as well as inform policy to increase PrEP uptake and adherence, address substance use, and decrease HIV transmission rates, and disparities.

PROJECT NARRATIVE This project seeks to investigate relationships between multiple aspects of cannabis use in relation to HIV prevention behaviors (e.g., pre-exposure prophylaxis [PrEP] use, adherence, and discontinuation) and (biological vulnerability to HIV infection) among Black gay, bisexual and other men who have sex with men (MSM), a population in the United States heavily impacted by HIV/AIDS.