Getting PrEPared for HIV Prevention Navigation: Young Black Gay Men Talk About HIV Prevention in the Biomedical Era

Biomedical HIV prevention strategies, such as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), represent new opportunities to reduce critically high HIV infection rates among young black men who have sex with men (YBMSM). We report results of 24 dyadic qualitative interviews (N=4...

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Bibliographic Details
Published in:	AIDS patient care and STDs Vol. 29; no. 9; p. 490
Main Authors:	Mutchler, Matt G, McDavitt, Bryce, Ghani, Mansur A, Nogg, Kelsey, Winder, Terrell J A, Soto, Juliana K
Format:	Journal Article
Language:	English
Published:	United States 01-09-2015
Subjects:	Adolescent African Americans - psychology African Continental Ancestry Group - psychology Anti-HIV Agents - administration & dosage Health Knowledge, Attitudes, Practice HIV Infections - drug therapy HIV Infections - ethnology HIV Infections - prevention & control Homosexuality, Male - ethnology Homosexuality, Male - statistics & numerical data Humans Interviews as Topic Los Angeles Male Patient Acceptance of Health Care Post-Exposure Prophylaxis Qualitative Research Risk-Taking Sexual Behavior Social Stigma Young Adult Los Angeles
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Summary:	Biomedical HIV prevention strategies, such as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), represent new opportunities to reduce critically high HIV infection rates among young black men who have sex with men (YBMSM). We report results of 24 dyadic qualitative interviews (N=48), conducted in Los Angeles, CA, exploring how YBMSM and their friends view PrEP and PEP. Interviews were analyzed using a grounded theory approach. Participants had widely divergent levels of knowledge about these prevention methods. Misconceptions and mistrust regarding PrEP were common, and concerns were expressed about PrEP-related stigma and the potential for gossip among peers who might assume a person on PrEP was HIV-positive. Yet participants also framed PrEP and PEP as valuable new options within an expanded "tool kit" of HIV prevention strategies that created possibilities for preventing new HIV infections, dating men with a different HIV status, and decreased anxiety about exposure to HIV. We organized themes around four main areas: (1) information and misinformation about biomedical HIV prevention; (2) expectations about PrEP, sexual behavior, and stigma; (3) gossip, disclosure, and "spreading the word" about PrEP and PEP; and (4) the roles of PrEP and PEP in an expanded HIV prevention tool kit. The findings suggest a need for guidance in navigating the increasingly complex array of HIV-prevention options available to YBMSM. Such "prevention navigation" could counter misconceptions and address barriers, such as stigma and mistrust, while helping YBMSM make informed selections from among expanded HIV prevention options.
ISSN:	1557-7449
DOI:	10.1089/apc.2015.0002