Accessing Pre-exposure Prophylaxis (PrEP): Perceptions of Current and Potential PrEP Users in Birmingham, Alabama

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

“…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.…”

Barriers to the Wider Use of Pre-exposure Prophylaxis in the United States: A Narrative Review

“…At the individual level, there are simple logistical constraints to accessing PrEP, exacerbated by socioeconomic inequalities. For example, individuals may experience difficulty in getting to the clinic [74] due to lack of transportation [46] or time constraints [75,76]. A 2016 National Survey on HIV in the Black community found that 38% of 787 participants were more than one hour's drive from a PrEP provider.…”

“…For example, improved accessibility and credibility of HIV prevention messaging in minority subpopulations has been proposed as a strategy to negate the impact of PrEP-related conspiracy beliefs [70]. Social media-based, peer-led interventions could also confer a significant population-level impact on PrEP uptake among young Black and Latinx individuals by addressing issues such as knowledge/awareness, Participants described substantial levels of stigma, including HIV-related stigma and discrimination from family, church, and community [185] cis cisgender, HIV human immunodeficiency virus, MSM men who have sex with men, PrEP pre-exposure prophylaxis, PWID people who inject drugs, TGM transgender men, TGW transgender women a Please see study of current and potential PrEP users in Alabama ' 'Sexual orientation' ' category, also applicable here [76] attitudes, stigma, and treatment access [118]; similar interventions could successfully reach transgender women and MSM. Counseling on the benefits of PrEP, and providing information and reassurance on the risk and monitoring of short-and long-term side effects, may also improve adherence to PrEP [119].…”

“…Odds of current PrEP use increased with age, parent sex communication, and increased family disclosure of sexual identity. Participants who reported being in a relationship were less likely to be using PrEP than single participants [ 182 ] Survey of MSM aged 18–25 years ( N = 236) Participants were less likely to use PrEP if they were in a relationship [ 183 ] Online surveys and focus groups of adolescents ( N = 56), most of whom were cis male (95%) and identified as gay (79%) A frequently reported barrier was homophobia in the form of disapproving parents and healthcare providers [ 74 ] Online focus groups of HIV-negative sexual and gender minority adolescents (aged 14–18 years) recruited from across the USA Participants asked a variety of questions about PrEP, including how or where to get PrEP without parents finding out [ 184 ] Geographic location a Focus groups of individuals at high risk of HIV in the Deep South ( N = 54), primarily Black MSM and women participating in substance use treatment Participants described substantial levels of stigma, including HIV-related stigma and discrimination from family, church, and community [ 185 ] cis cisgender, HIV human immunodeficiency virus, MSM men who have sex with men, PrEP pre-exposure prophylaxis, PWID people who inject drugs, TGM transgender men, TGW transgender women a Please see study of current and potential PrEP users in Alabama “Sexual orientation” category, also applicable here [ 76 ] …”

Socio-Sexual Experiences and Access to Healthcare Among Informal PrEP Users in the Netherlands

“…According to data from the European Centre for Disease Prevention and Control (ECDC) from 2019, formal access to PrEP is available only in 16 of 53 reporting countries in Europe and neighboring countries [4]. Access to PrEP has been limited due to structural barriers such as the high costs of PrEP, but also by a lack of PrEP implementation in existing healthcare settings [5][6][7][8][9]. As a consequence, some men who have sex with men (MSM) obtain PrEP via channels that have been labelled "informal".…”