HIV Pre-Exposure Prophylaxis (PrEP) among men who have sex with men: peer communication, engagement and social networks

Abstract

HIV Pre-Exposure Prophylaxis (PrEP) has renewed optimism in controlling the HIV epidemic, despite its continued growth among men who have sex with men (MSM). The popularity of dating-sexual dating apps and digital media platforms in exchanging information and experiences about PrEP on peer social networks is recognized. However, studies on contexts, motivations, and scope in HIV prevention are scarce. The article aims to understand the dynamics of virtual and face-to-face peer networks among MSM for the decision to use PrEP, its disclosure, and publicity. Qualitative study using semi-structured interviews with 48 PrEP users from five Brazilian cities. Most interviewees share information and experiences about PrEP in peer social networks. However, its publication reveals tensions arising from the permanence of stigmas associated with homosexuality and HIV. The protagonism in exposing the use of PrEP expresses commitment to attracting new users. The relevance of peer social networks in sharing experiences and information about PrEP has the potential to diversify the target audience and expand and democratize PrEP coverage in the country.

Exploring Barriers and Facilitators That Influence Uptake of Oral Pre-Exposure Prophylaxis Among Men Who Have Sex With Men in Bulawayo, Zimbabwe: Key Stakeholder’s Perspectives

“…It is reported in the literature that there is usually a stigma around PrEP users and labeling them promiscuous or sex workers ( Graham et al, 2022 ; Klein & Washington, 2020 ; Patrick et al, 2019 ; Pichon et al, 2022 ; Yu et al, 2021 ). There is also misconception and stigma where PrEP users are being labeled to be HIV positive, and some individuals confuse the taking of PrEP with the taking of ARVs meant to reduce the viral load ( Ahouada et al, 2020 ; Diabaté et al, 2021 ; Emmanuel et al, 2020 ; Graham et al, 2022 ; Grant et al, 2014 ; Harawa et al, 2016 ; Patrick et al, 2019 ; Pichon et al, 2022 ; Santos et al, 2022 ; Sundararajan et al, 2022 ). It is also reported by different scholars that there is stigma that is usually associated with sexual orientation as a significant number of communities in different countries have not fully embraced the key populations and acknowledged their existence and their rights ( Adeagbo et al, 2021 ; Grant et al, 2014 ; Harawa et al, 2016 ; Pelletier et al, 2019 ; Philbin et al, 2016 ; Santos et al, 2022 ; Voglino et al, 2021 ).…”

“…There is also misconception and stigma where PrEP users are being labeled to be HIV positive, and some individuals confuse the taking of PrEP with the taking of ARVs meant to reduce the viral load ( Ahouada et al, 2020 ; Diabaté et al, 2021 ; Emmanuel et al, 2020 ; Graham et al, 2022 ; Grant et al, 2014 ; Harawa et al, 2016 ; Patrick et al, 2019 ; Pichon et al, 2022 ; Santos et al, 2022 ; Sundararajan et al, 2022 ). It is also reported by different scholars that there is stigma that is usually associated with sexual orientation as a significant number of communities in different countries have not fully embraced the key populations and acknowledged their existence and their rights ( Adeagbo et al, 2021 ; Grant et al, 2014 ; Harawa et al, 2016 ; Pelletier et al, 2019 ; Philbin et al, 2016 ; Santos et al, 2022 ; Voglino et al, 2021 ). Certain writers have demanded that providers of sexual health services guarantee a decrease in stigmatization and that their services are free from discrimination ( Mgodi et al, 2023 ).…”

Forty years of the Brazilian response to HIV: reflections on the need for a programmatic shift and policy as a common good

“…Therefore, continuing to invest in “literacy for prevention” is essential, aiming at psychosocial emancipation, allowing people to find ways to use the potential of each technology to ensure protection in its various scenes. Moreover, PrEP has created new conditions for sexual scenes, in many cases eliminating negotiations about condom use, according to studies of gay men, who often publicly declare their use of PrEP, especially on dating apps 6 . We are thus facing a new era of the epidemic, in which the most affected communities have reformulated their sexual practices, for example, by incorporating condoms, seroadaptive practices, and now PrEP and treatment as prevention (TasP).…”

Quarenta anos da resposta brasileira ao HIV: reflexões sobre a necessidade do salto programático e a política como bem comum

“…Assim, é fundamental continuar a investir no "letramento para a prevenção", visando a uma emancipação psicossocial que permita, às pessoas, encontrar formas de usar o potencial de cada tecnologia para assegurar proteção em suas diversas cenas. Para além disso, é importante reconhecer que a PrEP criou, sim, novas condições para as cenas sexuais, em muitos casos eliminando negociações sobre o uso do preservativo, como mostram estudos com homens gays, que com frequência declaram publicamente seu uso de PrEP, principalmente em aplicativos de encontro 6 . Estamos, assim, diante de uma nova era da epidemia, em que comunidades mais afetadas reformularam suas práticas sexuais, como fizeram ao incorporar o preservativo, as práticas soroadaptativas e, agora, a PrEP e o tratamento como prevenção (TasP).…”