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Experiences of men who have sex with men when initiating, implementing, and persisting with HIV pre-exposure prophylaxis

Gillespie, David ORCID:, Wood, Fiona ORCID:, Williams, Adam, Ma, Richard, Bruin, Marijn de, Hughes, Dyfrig A., Jones, Adam T., Couzens, Zoe and Hood, Kerenza ORCID: 2022. Experiences of men who have sex with men when initiating, implementing, and persisting with HIV pre-exposure prophylaxis. Health Expectations 25 (4) , pp. 1332-1341. 10.1111/hex.13446

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Introduction HIV pre-exposure prophylaxis (PrEP) involves the use of antiretroviral medication in HIV-negative individuals considered to be at risk of acquiring HIV. It has been shown to prevent HIV and has been available in Wales since July 2017. Measuring and understanding adherence to PrEP is complex as it relies on the simultaneous understanding of both PrEP use and sexual activity. We aimed to understand the experiences of men who have sex with men (MSM) living in Wales initiating, implementing and persisting with HIV PrEP. Methods We conducted semistructured interviews with MSM PrEP users in Wales who participated in a cohort study of PrEP use and sexual behaviour. Following completion of the cohort study, participants were invited to take part in a semistructured interview about their experiences of taking PrEP. We aimed to include both individuals who had persisted with and discontinued PrEP during the study. The interview topic guide was informed by the ABC taxonomy for medication adherence and the theory of planned behaviour. We analysed our data using reflexive thematic analysis. Results Twenty-one participants were interviewed, five having discontinued PrEP during the cohort study. The developed themes focused on triggers for initiating PrEP, habitual behaviour, drivers for discontinuation and engagement with sexual health services. Stigma surrounding both PrEP and HIV permeated most topics, acting as a driver for initiating PrEP, an opportunity to reduce discrimination against people living with HIV, but also a concern around the perception of PrEP users. Conclusion This is the first study to investigate PrEP-taking experiences incorporating established medication adherence taxonomy. We highlight key experiences regarding the initiation, implementation and persistence with PrEP and describe how taking PrEP may promote positive engagement with sexual health services. These findings may be useful for informing PrEP rollout programmes and need to be explored in other key populations.

Item Type: Article
Date Type: Published Online
Status: Published
Schools: Medicine
Centre for Trials Research (CNTRR)
Additional Information: This is an open access article under the terms of the Creative Commons Attribution License
Publisher: Wiley Open Access
ISSN: 1369-6513
Date of First Compliant Deposit: 12 January 2022
Date of Acceptance: 12 January 2022
Last Modified: 09 May 2023 18:46

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