Abstract
Gay, bisexual, and other men who have sex with men (MSM) account for 60% of new HIV infections among Black Americans in the Southern United States (U.S.). Despite recommendations for frequent HIV testing and daily pre-exposure prophylaxis (PrEP) uptake, there remains a gap in PrEP uptake among these Black MSM in the Southern U.S. Artificial Intelligence (AI) chatbots have the potential to boost users' health awareness and medication adherence. This study aims to evaluate Black MSM' perspectives on the challenges to the uptake of PrEP and identify Black MSM-preferred chatbot functionalities and platforms for embedding AI chatbots. Five focus group discussions were conducted (February - March 2024) among 21 Black MSM in the Southern U.S. Interview transcripts were thematically analyzed according to challenges to PrEP uptake and the four domains of the Unified Theory of Acceptance and Use of Technology (UTAUT): performance expectancy, effort expectancy, facilitating conditions, and social influence. Black MSM identified lack of awareness or insufficient information, stigmatizations of sexuality, HIV, and PrEP, as well as concerns with side effects, and low self-perceived HIV vulnerability as the major challenges they faced in PrEP uptake. Moreover, chatbots were perceived as an acceptable option for delivering PrEP education (performance expectancy), especially with accessible, user-friendly interfaces (effort expectancy). Other desired features included simplifying access to PrEP information, incorporating culturally sensitive algorithms, upholding anonymity (social influence), and linking users to healthcare providers and resources (facilitating condition). The study highlights the multifaceted considerations for the adoption of AI chatbots as an HIV-prevention intervention among Black MSM in the Southern U.S.