Early Experiences Implementing Pre-exposure Prophylaxis (PrEP) for HIV Prevention in San Francisco

Liu, Albert; Cohen, Stéphanie; Follansbee, Stephen; Cohan, Deborah; Weber, Shannon; Sachdev, Darpun; Buchbinder, Susan

doi:10.1371/journal.pmed.1001613

Cited by 228 publications

(213 citation statements)

References 47 publications

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“…2 Despite demonstrated efficacy of antiretroviral pre-exposure prophylaxis (PrEP) in reducing HIV acquisition, evaluation of PrEP uptake and use outside of research settings remains limited. [3][4][5] Commonly cited barriers to PrEP implementation include limited awareness about PrEP, concerns about side-effects, adherence, cost, access, low perceived risk of HIV acquisition, and stigma. 2,4,6,7 Whether and how these barriers affect PrEP uptake and PrEP clinical programs in real-world settings is unknown.…”

Section: 4mentioning

confidence: 99%

Patient Experiences of Men Who Have Sex with Men Using Pre-Exposure Prophylaxis to Prevent HIV Infection

Parker

Chan

Oldenburg

et al. 2015

AIDS Patient Care and STDs

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Section: 4mentioning

confidence: 99%

Patient Experiences of Men Who Have Sex with Men Using Pre-Exposure Prophylaxis to Prevent HIV Infection

Parker

Chan

Oldenburg

et al. 2015

AIDS Patient Care and STDs

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“…Although MSM are a key population for biomedical HIV prevention, 1,[8][9][10] difficulties communicating about behavior in healthcare settings may hinder implementation. Prior studies have found that mistrust, disclosure difficulties, and internalized homophobia may limit healthcare access and delay presentation for care among MSM.…”

mentioning

confidence: 99%

A Qualitative Study of Medical Mistrust, Perceived Discrimination, and Risk Behavior Disclosure to Clinicians by U.S. Male Sex Workers and Other Men Who Have Sex with Men: Implications for Biomedical HIV Prevention

et al. 2015

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Access to biomedical HIV prevention technologies such as pre-exposure prophylaxis (PrEP) requires individuals to disclose risk behavior to clinicians, but experiences of discrimination and medical mistrust may limit disclosure among male sex workers and other MSM. We explored experiences of perceived discrimination, medical mistrust, and behavior disclosure among male sex workers compared to other men who have sex with men (MSM). We conducted 56 interviews with MSM and compared findings about medical mistrust, discrimination, and disclosure for 31 men who engaged in sex work vs. 25 men who did not. MSM who engaged in sex work reported more medical mistrust and healthcare discrimination due to issues beyond MSM behavior/identity (e.g., homelessness, substance use, poverty). MSM who did not report sex work described disclosing sex with men to clinicians more often. Both subgroups reported low PrEP awareness, but willingness to disclose behavior to obtain PrEP. Medical mistrust and perceived discrimination create barriers for sexual behavior disclosure to clinicians, potentially impeding access to PrEP and other forms of biomedical HIV prevention. These barriers may be higher among male sex workers compared to other MSM, given overlapping stigmas including sex work, substance use, homelessness, and poverty. An intersectionality framework for understanding multiple stigmas can help to identify how these dynamics may limit access to biomedical HIV prevention among male sex workers, as well as suggesting strategies for addressing stigmas to improve the delivery of PrEP and other HIV prevention approaches in this population.

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“…19 Liu and colleagues found that in addition to fear of being stigmatized by family and peers, potential PrEP users sensed judgment and resistance from medical providers providing PrEP. 25 Most notably, among all of these studies, concern around users being labeled as sexually deviant or too sexually adventurous seems to be a critical barrier to widespread acceptance of PrEP use. The insights gained from these exploratory studies highlighting stigma as a barrier are crucial to understand in more depth as biomedical interventions for HIV prevention become more widespread.…”

mentioning

confidence: 99%

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

Mutchler

McDavitt

Ghani

et al. 2015

AIDS Patient Care and STDs

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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 PrEPrelated stigma and the potential for gossip among peers who might assume a person on PrEP was HIV-positive.

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Early Experiences Implementing Pre-exposure Prophylaxis (PrEP) for HIV Prevention in San Francisco

Cited by 228 publications

References 47 publications

Patient Experiences of Men Who Have Sex with Men Using Pre-Exposure Prophylaxis to Prevent HIV Infection

Patient Experiences of Men Who Have Sex with Men Using Pre-Exposure Prophylaxis to Prevent HIV Infection

A Qualitative Study of Medical Mistrust, Perceived Discrimination, and Risk Behavior Disclosure to Clinicians by U.S. Male Sex Workers and Other Men Who Have Sex with Men: Implications for Biomedical HIV Prevention

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

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