Perceived HIV risk, PrEP knowledge, and substance use in HBCU students: Identifying risk profiles to innovate primary prevention

<b>Objective:</b> To classify HIV-risk profiles for HBCU students to inform primary prevention. <b>Participants:</b> 244 HBCU students participated in the study. <b>Methods:</b> Students completed a demographic questionnaire and instruments measuring attitudes, knowledge, and beliefs about PrEP, perceived HIV risk, and drug use. Data were analyzed quantitatively including latent profile analysis. <b>Results:</b> Four risk profiles emerged: profile 1 (30.33%)-lowest PrEP scores, below-average perceived risk, low drug use; profile 2 (42.21%)-lowest perceived risk and drug use, above-average PrEP scores; profile 3 (22.13%)-highest PrEP and perceived risk scores, low drug use; and profile 4 (5.33%)-highest drug use, above-average PrEP and perceived risk scores. <b>Conclusion:</b> Findings provide preliminary support for classifying HBCU students by HIV-risk profiles to guide primary prevention. Universal prevention may be well-suited for students in profiles 1 and 2. Further assessment may be needed to determine selective and targeted/indicated prevention interventions for students in profiles 3 and 4 respectively.