We have a duty to eradicate HIV in the community, in the world' : successful PrEP use among black men who have sex with men
Abstract
[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT REQUEST OF AUTHOR.] Black men who have sex with men (BMSM) have a 50% lifetime risk of HIV infection. The HIV epidemic continues to be a perplexing health issue, despite the availability of a highly effective biomedical prevention strategy. Pre-exposure prophylaxis (PrEP) uptake is suboptimal among BMSM: a priority population that accounts for over one fourth of all new HIV diagnoses in the United States. Most research endeavors have focused on identifying barriers to PrEP with less emphasis on facilitators of PrEP uptake. This qualitative study was undertaken to gain a better understanding about the factors that motivate BMSM to seek PrEP and the strategies that resulted in successful uptake. In-depth individual interviews were conducted with Midwestern BMSM (n=12) who were successfully taking PrEP for over one year. The men were sophisticated, privately insured healthcare consumers and yet, the overarching theme that emerged from the data was that obtaining PrEP was a "long, hard road". Facilitators to PrEP access included having an important person, insight into the roles of stigma, sexual partner mistrust, and the desire to be a part of something bigger than oneself. Also prevalent in the data were descriptions about barriers to PrEP access. Men in this study felt strongly that HIV prevention is everyone's responsibility. Findings have important implications for research and clinical practice. Strategies that can decrease healthcare system barriers and help simplify the process to access PrEP are greatly needed.
Degree
Ph. D.
Thesis Department
Rights
Access is limited to the campuses of the University of Missouri