P323 STI prevention in black men who have sex with men taking PrEP: concerns, cognizance, condom norms and more

Clement, Meredith E.; Beckford, Jeremy; Siren, Julia; Adorno, Marie; LeGrand, Sara; Bennett, Marsha; Corneli, Amy

doi:10.1136/sextrans-2021-sti.377

Cited by 3 publications

(3 citation statements)

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“…During the FGDs, participants were first shown data from previous in-depth interviews (IDIs) with BMSM in which drivers of sexual risk taking and facilitators of and barriers to STI prevention were discussed [9]. Participants were asked to debate and discuss the findings from the IDIs including any topics that were controversial.…”

Section: Fgd Contentmentioning

confidence: 99%

“…Among BMSM, sexual risk behaviors including condomless anal intercourse are associated with social factors such as lack of peer support, medical mistrust, and self-reported experiences of homophobia or racism [3][4][5][6][7]. Our previous studies have aimed to better characterize social factors as potential barriers to STI risk reduction practices among BMSM using HIV pre-exposure prophylaxis (PrEP) [8,9]. Although we found moderate levels of perceived stigma and medical mistrust in this population, we also found that participants desired and were willing to engage in STI prevention strategies.…”

Section: Introductionmentioning

confidence: 99%

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Development of an mHealth App to Support the Prevention of Sexually Transmitted Infections Among Black Men Who Have Sex With Men Engaged in Pre-exposure Prophylaxis Care in New Orleans, Louisiana: Qualitative User-Centered Design Study

Clement¹,

Lovett²,

Caldwell³

et al. 2023

JMIR Form Res

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Background Sexual health disparities exist for Black men who have sex with men (BMSM) in New Orleans, Louisiana. Rates of sexually transmitted infections (STIs) are high for both BMSM and those taking HIV pre-exposure prophylaxis (PrEP). Objective In this study, we introduced an existing PrEP adherence app to new potential users—BMSM engaged in PrEP care in New Orleans—to guide app adaptation with STI prevention features and tailoring for the local context. Methods Using a user-centered design, we conducted 4 focus group discussions (FGDs), with interim app adaptations from December 2020 to March 2021. During the FGDs, a video of the app, app website, and mock-ups were shown to participants. We asked about facilitators of and barriers to STI prevention in general, current app use, impressions of the existing app, new app features to potentially facilitate STI prevention, and how the app should be tailored for BMSM. We used applied qualitative thematic analysis to identify themes and needs of the population. Results Overall, 4 FGDs were conducted with 24 BMSM taking PrEP. We grouped themes into 4 categories: STI prevention, current app use and preferences, preexisting features and impressions of the prep’d app, and new features and modifications for BMSM. Participants noted concern about STIs and shared that anxiety about some STIs was higher than that for others; some participants shared that since the emergence of PrEP, little thought is given to STIs. However, participants desired STI prevention strategies and suggested prevention methods to implement through the app, including access to resources, educational content, and sex diaries to follow their sexual activity. When discussing app preferences, they emphasized the need for an app to offer relevant features and be easy to use and expressed that some notifications were important to keep users engaged but that they should be limited to avoid notification fatigue. Participants thought that the current app was useful and generally liked the existing features, including the ability to communicate with providers, staff, and each other through the community forum. They had suggestions for modifications for STI prevention, such as the ability to comment on sexual encounters, and for tailoring to the local context, such as depictions of iconic sights from the area. Mental health emerged as an important need to be addressed through the app during discussion of almost all features. Participants also stressed the importance of ensuring privacy and reducing stigma through the app. Conclusions A PrEP adherence app was iteratively adapted with feedback from BMSM, resulting in a new app modified for the New Orleans context and with STI prevention features. Participants gave the app a new name, PCheck, to be more discreet. Next steps will assess PCheck use and STI prevention outcomes.

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Section: Fgd Contentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Development of an mHealth App to Support the Prevention of Sexually Transmitted Infections Among Black Men Who Have Sex With Men Engaged in Pre-exposure Prophylaxis Care in New Orleans, Louisiana: Qualitative User-Centered Design Study

Clement¹,

Lovett²,

Caldwell³

et al. 2023

JMIR Form Res

View full text Add to dashboard Cite

show abstract

“…In addition, rates of STIs have been shown to be high in those on HIV preexposure prophylaxis (PrEP) 5,6 . Where these risk groups converge—in Black MSM (BMSM) engaged in HIV PrEP care in the South—sexual health disparities are profound; yet, although prior research has evaluated the relationship between HIV PrEP and STIs in MSM populations, little research has focused on STI prevention specifically in BMSM 7,8 . Additional prevention research, including efforts to determine the acceptability of prevention strategies, is needed, particularly in the wake of recent studies demonstrating the efficacy of doxycycline for bacterial STI prophylaxis 9–11 .…”

mentioning

confidence: 99%

Sexually Transmitted Infection Prevention Perspectives in Black Men Who Have Sex With Men Taking Preexposure Prophylaxis in New Orleans

Clement,

Beckford,

Lovett

et al. 2023

Sexual Trans Dis

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Introduction Profound sexual health disparities exist for Black men who have sex with men (MSM) in the US South, including high prevalence of sexually transmitted infections (STIs). STI prevention strategies beyond condoms are needed for Black MSM taking PrEP. Methods We conducted in-depth interviews with Black MSM taking PrEP in New Orleans, Louisiana. Informed by the Health Belief Model, we asked about participants’ perceived susceptibility, severity, and concerns regarding STIs, and perceived benefits of STI prevention. We also asked about willingness to use various STI prevention strategies, including antibiotic prophylaxis. Interviews were audio-recorded and analyzed using applied thematic analysis. Results We interviewed 24 Black MSM ages 18 to 36; half had a recent STI diagnosis. Most participants were concerned about receiving an STI diagnosis, noting shame or disappointment; physical effects were concerning but infrequently considered. Participants described being less likely to use condoms with routine partners or those taking PrEP. Most reported being willing to engage in each of the six prevention strategies discussed. Conclusion Black MSM taking PrEP voiced concern about STIs and many noted they infrequently use condoms. They were willing to engage in methods focused on preventing STIs on an individual- or population-level.

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Development of an mHealth App to Support the Prevention of Sexually Transmitted Infections Among Black Men Who Have Sex With Men Engaged in Pre-exposure Prophylaxis Care in New Orleans, Louisiana: Qualitative User-Centered Design Study (Preprint)

Clement¹,

Lovett²,

Caldwell³

et al. 2022

Preprint

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BACKGROUND Sexual health disparities exist for Black men who have sex with men (BMSM) in New Orleans, Louisiana. Rates of sexually transmitted infections (STIs) are high for both BMSM and those taking HIV pre-exposure prophylaxis (PrEP). OBJECTIVE In this study, we introduced an existing PrEP adherence app to new potential users in New Orleans, Louisiana to guide app adaptation with STI prevention features and tailoring for the local context. METHODS Four FGDs were conducted with 24 BMSM taking PrEP. We grouped themes into four categories: STI prevention, app preferences, impressions of the app prototype, and adaptations. Participants desired STI prevention strategies and suggested prevention methods to implement through the app. They emphasized the need for an app to offer relevant features and be easy-to-use. Participants thought the current app was useful and generally liked the existing features. They had suggestions for modifications for STI prevention, such as the ability to track and comment on sexual encounters, and for tailoring to the local context, such as depictions of iconic sights from the area. Participants also stressed the importance of ensuring privacy and reducing stigma through the app. RESULTS Four FGDs were conducted with 24 BMSM taking PrEP. Themes are grouped into four categories: STI prevention, app preferences, impressions of the app prototype, and adaptations. Participants desired STI prevention strategies and suggested prevention methods to implement through the app. They emphasized the need for an app to offer relevant features and be easy-to-use. Participants thought the current app was useful and generally liked the existing features. They had suggestions for modifications for STI prevention, such as the ability to track and comment on sexual encounters, and for tailoring to the local context, such as depictions of iconic sights from the area. Participants also stressed the importance of ensuring privacy and reducing stigma through the app. CONCLUSIONS A PrEP adherence app was iteratively adapted with feedback from Black MSM, resulting in a new app modified for the New Orleans context and with STI prevention features. Next steps will assess usage and STI prevention outcomes.

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P323 STI prevention in black men who have sex with men taking PrEP: concerns, cognizance, condom norms and more

Cited by 3 publications

References 0 publications

Development of an mHealth App to Support the Prevention of Sexually Transmitted Infections Among Black Men Who Have Sex With Men Engaged in Pre-exposure Prophylaxis Care in New Orleans, Louisiana: Qualitative User-Centered Design Study

Development of an mHealth App to Support the Prevention of Sexually Transmitted Infections Among Black Men Who Have Sex With Men Engaged in Pre-exposure Prophylaxis Care in New Orleans, Louisiana: Qualitative User-Centered Design Study

Sexually Transmitted Infection Prevention Perspectives in Black Men Who Have Sex With Men Taking Preexposure Prophylaxis in New Orleans

Development of an mHealth App to Support the Prevention of Sexually Transmitted Infections Among Black Men Who Have Sex With Men Engaged in Pre-exposure Prophylaxis Care in New Orleans, Louisiana: Qualitative User-Centered Design Study (Preprint)

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