Background: Despite the availability of Pre-Exposure Prophylaxis (PrEP) which can prevent HIV, uptake among African Americans remain alarming low. Given the alarming rates of new infections among Black MSM, there is a need to better understand barriers and facilitators to uptake and adherence to PrEP among this population.

Methods: Utilizing data from ACCELERATE! Initiative, we examined correlates of PrEP uptake and adherence of 322 participants who enrolled in this community-based study in Jackson, Mississippi.

Results: Findings revealed the following reasons for lack of uptake of PrEP: (1) did not perceive themselves at risk (20%; n = 16/80); (2) did not want to take a pill every day (20%; n = 16); (3) concerned about side effects (30%; n = 24/80); and (4) concerned others would think they were HIV positive (17.5%; n = 14/80). Meanwhile, those who were taking PrEP indicated positive effects related to PrEP use including (1) feel/felt risk for HIV decreased (100%; n = 72/72); (2) feel/felt more in control of my health 72%; n = 52/72); 3) ever experienced side effects (33%; n = 24/72).

Conclusions: Despite awareness and knowledge of where to obtain PrEP, barriers still exist in uptake of PrEP among Black MSM. There is an urgent need for culturally-appropriate HIV prevention programs such as ACCELERATE! to better support Black MSM in managing their risk and improving uptake and engagement in PrEP.