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

Gillespie, David, Wood, Fiona, Williams, Adam, Ma, Richard, de Bruin, Marijn, Hughes, Dyfrig A ORCID: 0000-0001-8247-7459, Jones, Adam T, Couzens, Zoe and Hood, Kerenza
(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.

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<h4>Introduction</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.<h4>Patient and public contribution</h4>PrEP users, in addition to PrEP providers and representatives of HIV advocacy and policy, were involved in developing the topic guide for this study.

Item Type: Article
Uncontrolled Keywords: HIV, medication adherence, pre-exposure prophylaxis, qualitative research, sexual and gender minorities, sexual behaviour
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User: Symplectic Admin
Date Deposited: 27 May 2022 08:33
Last Modified: 18 Jan 2023 21:00
DOI: 10.1111/hex.13446
Open Access URL: https://doi.org/10.1111/hex.13446
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3155588