Targeting HIV Prevention Inequities: A Pilot ACT-Based Prep Intervention for Young Black MSM in the Southern United States

Abstract

Pre-exposure prophylaxis (Prep) has demonstrated considerable effectiveness in reducing HIV transmission among high-risk populations. However, disparities in Prep uptake persist, particularly among young Black men who have sex with men (MSM) in the Southern United States, a region disproportionately burdened by HIV. The ACTPrEP pilot study protocol presents an acceptance and commitment therapy (ACT)-based behavioral intervention aimed at improving Prep initiation, adherence, and retention among this demographic. This study proposes a culturally tailored, stigma-sensitive, and psychologically grounded approach designed to address not only behavioral barriers but also contextual and structural challenges related to HIV prevention. The protocol integrates individual counseling, motivational enhancement strategies, and mobile health components to ensure engagement and continuity of care. This paper details the study’s methodology, theoretical grounding, expected outcomes, and pilot testing framework, along with a discussion of the broader implications for Prep interventions in marginalized communities.