Access to HIV Pre-exposure Prophylaxis in Practice Settings: a Qualitative Study of Sexual and Gender Minority Adults’ Perspectives

Sun, Christina J.; Anderson, Kirsten M.; Bangsberg, David R.; Toevs, Kim; Morrison, Dayna; Wells, Caitlin; Clark, Pete L.; Nicolaidis, Christina

doi:10.1007/s11606-019-04850-w

Cited by 21 publications

(58 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Of the 34 participants in this study, approximately two-thirds of them (68%, n = 23) obtained PrEP from their nonlocal PCP because there were no PrEP-providing clinics in their area, and their local PCP was unknowledgeable about PrEP, unwilling to prescribe it, and exhibited negative reactions to sex and sexuality. These findings are consistent with studies exploring uptake barriers among U.S. MSM considering PrEP or MSM already using PrEP (Hubach et al, 2017;Maloney et al, 2017;Rice et al, 2019;Sun et al, 2019). The perceived clinical care barriers in the above studies became reality for our participants.…”

Section: Discussionsupporting

confidence: 91%

“…Petroll et al 2017found 96% of PCPs who never prescribed PrEP but who had ap-propriate PrEP knowledge would still refer PrEP-eligible patients to other providers. Although previous studies have shown some MSM feel having a sex-positive PCP is necessary to disclose their PrEP interest and sexual behaviors (Hubach et al, 2017;Maloney et al, 2017;Sun et al, 2019), some PCPs feel uncomfortable discussing sexual behaviors with PrEP-eligible patients (Blumenthal et al, 2015;Petroll et al, 2017;Wood et al, 2018). PrEP implementation interventions for PCPs should focus more on inclusive sexual history taking and LGBTQ+ cultural competency care, in addition to increasing PrEP knowledge.…”

Section: Discussionmentioning

confidence: 99%

“…One in eight PrEP-eligible MSM live 30 minutes away from a PrEP provider (Siegler et al, 2019). Rural MSM have previously reported PrEP care continuum services (e.g., PrEP-providing clinics, HIV testing sites) are not available in their communities, and they would have to travel to specialists if they wanted to adopt PrEP (Hubach et al, 2017;Maloney et al, 2017;Sun et al, 2019). Although this lack of PrEP infrastructure and driving time is not exclusively unique to rural areas, rural areas are less likely to have PrEP-providing clinics, infectious disease, and LGBTQ+ health specialists (McKenney et al, 2018;Pellowski, 2013;Schafer et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Exploring the Pre-exposure Prophylaxis (PrEP) Health Care Experiences Among Men Who Have Sex With Men (MSM) Who Live in Rural Areas of the Midwest

Owens

Hubach

Williams

et al. 2020

AIDS Education and Prevention

View full text Add to dashboard Cite

Most pre-exposure prophylaxis (PrEP) research samples men who have sex with men (MSM) who live in metropolitan cities. There is a limited understanding of the PrEP experiences among rural MSM. Thirty-four semi-structured interviews were conducted to explore the PrEP health care experiences among 34 rural Midwestern MSM. Of the 34 participants, 23 obtained PrEP from their non-primary care provider (PCP). Three themes were present: (1) PrEP is unavailable in rural areas, (2) PrEP is inaccessible in rural areas due to PCPs being unwilling to prescribe PrEP, and (3) PrEP services are unamicable in rural areas due to stigmatizing attitudes and behaviors of PCPs. It is important to address PrEP care continuum factors in all settings; however, these factors are often exacerbated in rural areas due to social determinants. Without further research and programming, organizational and social determinants may contribute to lower rates of PrEP outcomes in rural areas.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Exploring the Pre-exposure Prophylaxis (PrEP) Health Care Experiences Among Men Who Have Sex With Men (MSM) Who Live in Rural Areas of the Midwest

Owens

Hubach

Williams

et al. 2020

AIDS Education and Prevention

View full text Add to dashboard Cite

show abstract

“…The 23 people included in this analysis were a subset of LGBTQ participants from a qualitative study of PrEP access and uptake in practice settings (Sun et al, 2018). We recruited participants who were 18 years or older, a resident of Oregon, and reported interest in using PrEP, or past or current PrEP use, through word-of-mouth and flyers (print and electronic) distributed by AIDS service organizations, LGBTQ community centers, and local health departments.…”

Section: Participants Recruitment and Eligibilitymentioning

confidence: 99%

“Little Tablets of Gold”: An Examination of the Psychological and Social Dimensions of PrEP Among LGBTQ Communities

Sun

Anderson

Toevs

et al. 2019

AIDS Education and Prevention

Self Cite

View full text Add to dashboard Cite

There are significant psychological, social, and cultural dimensions to the HIV epidemic in the United States, especially among lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities. Biomedical HIV treatment has been shown to impact these dimensions. However, there is little understanding of the real-world psychosocial and sociocultural effects of the latest biomedical HIV prevention strategy, HIV pre-exposure prophylaxis (PrEP). This study explored the psychosocial and sociocultural dimensions of PrEP use among LGBTQ adults. We interviewed 23 LGBTQ adults who were current or former users of PrEP. Results included that PrEP users' experiences were shaped by multiple forms of stigma. Participants were highly motivated to challenge PrEP stigma and to support PrEP use among other community members.Lastly, participants described positive impacts on their individual well-being and their sexual partnerships. Findings suggest that PrEP has significant impacts beyond biomedical outcomes for both the individuals who use PrEP and their communities.

show abstract

“…Three areas were found to be of interest within the papers: the specialty responsible for PrEP provision (also known as the 'Purview Paradox'), the setting in which the services should be held and how these two elements operate together within a larger framework. Firstly, the 'Purview Paradox' was reported in a number of articles [55][56][57][58][59][60][61][62][63][64]. Some authors viewed sexual health workers as 'first adopters' in PrEP service delivery due to on-site expertise, [65] whilst others favored primary care staff as they are the first point of contact for high-risk patients [55,65,66].…”

Section: Theme One: Prep Service Aspects Settings and Staffmentioning

confidence: 99%

Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Men Who Have Sex with Men (MSM): A Scoping Review on PrEP Service Delivery and Programming

et al. 2020

View full text Add to dashboard Cite

Pre-exposure prophylaxis (PrEP) is an evidence-based new biomedical HIV prevention intervention, which involves the pre-emptive use of daily (or event-based) antiretroviral drugs, to reduce risk of HIV acquisition if exposed. PrEP has recently been positioned as an integral prevention tool to reduce HIV acquisition risk among men who have sex with men (MSM) at country-level and within global prevention strategies. Given this global scale up of PrEP, we conducted a scoping review of extant international literature documenting service related perspectives, models and lessons learnt in PrEP programming for MSM. A systematic search of literature was conducted, and restricted to English language records in the timeframe 2008 to February 2019. Eligibility criteria centered on whether studies broadly described PrEP programming and service delivery for MSM as well as health communication. Following exclusion of ineligible records and removal of duplicates, 84 records were charted and thematically analysed according to scoping review methods. Four themes emerged from the thematic analysis of data; ‘PrEP service aspects, settings and staff’; ‘PrEP prescriber experiences, therapeutic alliance and care planning’; ‘PrEP adherence within formal service structures’; and ‘Multi-disciplinary and innovative PrEP care pathways’. The review highlights the complexities in providing optimal PrEP services for MSM by mapping and illustrating the importance of understanding the informal and formal routes to PrEP use among this HIV risk population; the barriers to uptake; the requirement for the presence of a positive therapeutic alliance between patient and prescriber in supporting patient initiation and adherence to PrEP regimes; and the need for availability in different culturally and ethnically sensitive models of PrEP service delivery according to low to high risk groups within the MSM communities.

show abstract

Access to HIV Pre-exposure Prophylaxis in Practice Settings: a Qualitative Study of Sexual and Gender Minority Adults’ Perspectives

Cited by 21 publications

References 54 publications

Exploring the Pre-exposure Prophylaxis (PrEP) Health Care Experiences Among Men Who Have Sex With Men (MSM) Who Live in Rural Areas of the Midwest

Exploring the Pre-exposure Prophylaxis (PrEP) Health Care Experiences Among Men Who Have Sex With Men (MSM) Who Live in Rural Areas of the Midwest

“Little Tablets of Gold”: An Examination of the Psychological and Social Dimensions of PrEP Among LGBTQ Communities

Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Men Who Have Sex with Men (MSM): A Scoping Review on PrEP Service Delivery and Programming

Contact Info

Product

Resources

About