What's PrEP?: Peer Navigator Acceptability among Minority MSM in Washington

Abstract

Background: Peer navigation is a promising strategy to link at-risk minority men who have sex with men (MSM) to HIV prevention services including pre-exposure prophylaxis (PrEP). Methods: Thirty-two Black and 63 Latinx HIV-negative MSM living in western Washington completed a survey examining attitudes towards peer navigation and PrEP. Factor analysis derived a score for peer navigator acceptability, and linear regression identified associations with this outcome . Results: Forty-eight percent were interested in peer navigation. Being insured, higher sexual stigma, and higher PHQ-9 score were associated with higher acceptability, while higher income and having a regular medical provider were associated with lower acceptability. In multivariable analysis, higher sexual stigma predicted higher acceptability, while higher income predicted lower acceptability. Conclusion: Men preferred that peers be matched on sexual orientation, race, age and culture. Peer navigation interventions to reach minority men should address stigma, focus on lower-income men, and try to match peers to clients to the extent possible. Key words: HIV prevention, pre-exposure prophylaxis, Black, Latinx, men who have sex with men

Intervening for HIV prevention and mental health: a review of global literature

“…Two studies showed that distinct categories of mental disorder symptoms were associated with lower adherence to PrEP: anxiety symptoms and a history of childhood trauma [87], baseline depression and substance use among MSM in a PrEP adherence trial [88]. A third study reported higher depression scores were significantly related to greater acceptability of peer navigation to assist with PrEP engagement among Black and Latinx MSM [89]. A fourth study found no relationship of depressive symptoms to PrEP adherence, but harmful alcohol use and moderate/high-risk cocaine use predicted nonadherence [90].…”

“…In these cases, the negative effect of poor mental health may be mitigated by other factors that facilitate taking action (e.g. high perceived self-efficacy [60]), or poor mental health may enhance recognition of vulnerability and a need for support [77,89]. Evidence also showed that learning one's HIV status, whether negative or positive, did not worsen depressive symptoms or increase suicidality [79].…”

Salud y Orgullo Mexicano: Development of a Culturally Specific Transnational Linkage and Retention in Care Intervention for Mexican Men Who Have Sex with Men Living with HIV in Chicago

“…The design team included members who both contributed to the development of Project IN-CARE and had experience implementing the intervention. Shared identities and life experience of peers living with HIV function as a means to provide social and emotional support and education to patients [14,15]. As HIV-related stigma, homophobia, fear, non-proficiency in the English language, and lack of culturally competent care are often barriers to Mexican men remaining in HIV care, our team prioritized selecting a peer-health model to include in the adaptation process [10,[12][13][14].…”

“…Shared identities and life experience of peers living with HIV function as a means to provide social and emotional support and education to patients [14,15]. As HIV-related stigma, homophobia, fear, non-proficiency in the English language, and lack of culturally competent care are often barriers to Mexican men remaining in HIV care, our team prioritized selecting a peer-health model to include in the adaptation process [10,[12][13][14]. Prior research has shown that Promotores de Salud (peer health workers) are effective at improving healthcare service utilization by Mexican men living with HIV by helping them navigate obstacles to accessing and remaining in HIV care [15][16][17].…”

Mind the Gap: HIV Prevention Among Young Black Men Who Have Sex with Men

“…HIV prevention efforts targeting YBMSM should be developed and implemented based on the voices, perspectives, and priorities of YBMSM themselves [ 85 ]. Several models of community-informed practices including engaging priority populations in the development of prevention messages and campaigns [ 86 ], incorporation of youth or community advisory boards to inform clinical programming [ 87 ], and integration of peer or near-peer navigators with shared identity or experiences with YBMSM [ 88 ] have demonstrated promising effects.…”