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However, limited research has examined initiation and adherence to PrEP<\/jats:styled-content> among Black MSM<\/jats:styled-content> (BMSM<\/jats:styled-content>) in the United States (US<\/jats:styled-content>) who are disproportionately represented among newly HIV<\/jats:styled-content> infected and late to care individuals. This research reports on the HIV<\/jats:styled-content> Prevention Trials Network 073 (HPTN<\/jats:styled-content> 073) study aimed to examine PrEP<\/jats:styled-content> initiation, utilization and adherence among Black MSM<\/jats:styled-content> utilizing the theoretically principled, culturally informed and client\u2010centered care coordination (C4) model.<\/jats:p><\/jats:sec>Methods<\/jats:title>The HPTN<\/jats:styled-content> 073 study enrolled and followed 226 HIV<\/jats:styled-content>\u2010uninfected Black MSM<\/jats:styled-content> in three US<\/jats:styled-content> cities (Los Angeles, CA<\/jats:styled-content>; Washington DC<\/jats:styled-content>; and Chapel Hill, NC<\/jats:styled-content>) from February 2013 through September 2015. Study participants were offered once daily oral emtricitabine\/tenofovir (FTC<\/jats:styled-content>\/TDF<\/jats:styled-content>) PrEP<\/jats:styled-content> combined with C4 and followed up for 52\u00a0weeks. Participants received HIV<\/jats:styled-content> testing, risk reduction education and clinical monitoring.<\/jats:p><\/jats:sec>Results<\/jats:title>Of the 226 men enrolled, 178 participants initiated PrEP<\/jats:styled-content> (79%), and of these 64% demonstrated PrEP<\/jats:styled-content> utilization at week 26 (mid\u2010point of the study) based on pharmacokinetic testing. Condomless anal sex with an HIV<\/jats:styled-content>\u2010infected or unknown status casual male partner was statistically significantly associated with a greater likelihood of PrEP<\/jats:styled-content> initiation (adjusted odds ratio (OR<\/jats:styled-content>) 4.4, 95% confidence interval (CI<\/jats:styled-content>) 1.7, 11.7). Greater age (\u226525 vs. <25, OR<\/jats:styled-content> 2.95, 95% CI<\/jats:styled-content> 1.37 \u20136.37), perception of having enough money (OR<\/jats:styled-content> 3.6, 95% CI<\/jats:styled-content> 1.7 to 7.7) and knowledge of male partner taking PrEP<\/jats:styled-content> before sex (OR<\/jats:styled-content> 2.22, 95% CI<\/jats:styled-content> 1.03 to 4.79) were statistically significantly associated with increased likelihood of PrEP<\/jats:styled-content> adherence at week 26. Annualized HIV<\/jats:styled-content> incidence was 2.9 (95% CI<\/jats:styled-content> 1.2 to 7.9) among those who initiated PrEP<\/jats:styled-content>, compared to 7.7 (95% CI<\/jats:styled-content> 2.5 to 24.1) among those who did not initiate PrEP<\/jats:styled-content> (p<\/jats:italic>\u00a0=\u00a00.18).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Results suggest a high level of PrEP<\/jats:styled-content> initiation among at\u2010risk Black MSM<\/jats:styled-content>, a group historically characterized as hard to reach. The data support the importance of addressing contextual factors that affect PrEP<\/jats:styled-content> initiation and adherence, and of additional research on the ultimate benefit of PrEP<\/jats:styled-content> in HIV<\/jats:styled-content> prevention among Black MSM<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25223","type":"journal-article","created":{"date-parts":[[2019,2,15]],"date-time":"2019-02-15T11:27:18Z","timestamp":1550230038000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":99,"title":["Pre\u2010exposure prophylaxis initiation and adherence among Black men who have sex with men (MSM<\/scp>) in three US cities: results from the HPTN<\/scp> 073 study"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9200-920X","authenticated-orcid":false,"given":"Darrell P","family":"Wheeler","sequence":"first","affiliation":[{"name":"School of Social Welfare University at Albany \u2013 SUNY Albany NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheldon D","family":"Fields","sequence":"additional","affiliation":[{"name":"School of Health Professions New York Institute of Technology New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geetha","family":"Beauchamp","sequence":"additional","affiliation":[{"name":"Statistical Center for HIV\/AIDS Research & Prevention (SCHARP) Vaccine and Infectious Disease Division (VIDD) Fred Hutchinson Cancer Research Center Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying Q","family":"Chen","sequence":"additional","affiliation":[{"name":"Statistical Center for HIV\/AIDS Research & Prevention (SCHARP) Vaccine and Infectious Disease Division (VIDD) and Public Health Sciences Division Fred Hutchinson Cancer Research Center Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynda M","family":"Emel","sequence":"additional","affiliation":[{"name":"Statistical Center for HIV\/AIDS Research & Prevention (SCHARP) Vaccine and Infectious Disease Division (VIDD) Fred Hutchinson Cancer Research Center Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Hightow\u2010Weidman","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases University of North Carolina at Chapel Hill Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Hucks\u2010Ortiz","sequence":"additional","affiliation":[{"name":"John Wesley Community Health Institute, Inc. 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