The effective use of antiretroviral therapy (ART) has seen an increasing number of people living with HIV. ART reduces the viral load and allows the body’s immunity to recover when used according to prescription. Men who have sex with other men (MSM) are at greater risk of contracting HIV, and many of them have contracted the disease. Black men in this category are worse off because of poor access to ART or poor adherence to the ART treatment regimens (Fuchs et al., 2018). The suboptimal adherence to ART is responsible for poor treatment outcomes, higher cost of treatment, more hospitalization, and more deaths among black MSM. There is a need for strategies to promote adherence to ART among Black MSM to live longer, fuller lives.

Research has shown that the rate of HIV infections among Black MSM has gone down significantly (Center for Disease Control and Prevention (CDC)). In 2018, only 26% of total diagnosed cases were Black MSM. By contrast, the figures were at 38% two years earlier and 41% in 2014. Regardless, it is still evident that the rate of infection among Black MSM is still higher than that of MSM among other races (CDC, 2016). Evidently, the rate of HIV has gone down due to all-inclusive HIV prevention measures and primary and secondary biomedical HIV interventions. Nevertheless, only a small percentage of MSM have access to such programs, due to fear of rejection and stigmatization from family and society (Homero et al, 2016). Other factors include; Level of education, substance abuse, and socioeconomic status.

In a study carried out in Mississippi among PLWHA in November 2007, it was discovered that, the level of education and employment status were among the key factors that influenced a PLWHA to fail to maintain high rates of adherence. Of the 72 participants in the study, 51 who failed in adherence were unemployed in comparison to 21 that were fully employed. The study also showed that among the participants who missed their medication, 48 of them had an education of high school and below, while 23 had gone beyond high school (Amico et al 2007). A similar study carried out in Houston (2007-2009) showed that people who abused substances tended to have high levels of non-adherence in comparison to those who did not. In the study, the rates of non-adherence among smokers were 21% higher than that of non-smokers. Alcohol usage and use of illegal drugs similarly contributed to non-adherence.