Perspectives and Factors Related to Pre-exposure Prophylaxis Use Among Young Men Who Have Sex With Men in the United States: A Mixed-Methods Study on the Role of History of PrEP Use

Junye Ma; Zach Soberano; Bryce F Stamp; Matthew Rosso; Lisa Hightow-Weidman; Kimberly A Powers; Jacob Benjamin Stocks; Sybil Hosek; Keith J Horvath

doi:10.1097/JNC.0000000000000489

Perspectives and Factors Related to Pre-exposure Prophylaxis Use Among Young Men Who Have Sex With Men in the United States: A Mixed-Methods Study on the Role of History of PrEP Use

J Assoc Nurses AIDS Care. 2024 Aug 29. doi: 10.1097/JNC.0000000000000489. Online ahead of print.

Authors

Junye Ma¹, Zach Soberano, Bryce F Stamp, Matthew Rosso, Lisa Hightow-Weidman, Kimberly A Powers, Jacob Benjamin Stocks, Sybil Hosek, Keith J Horvath

Affiliation

¹ Junye Ma, MA, is a PhD Student in the San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA. Zach Soberano, BA, is a Research Study Coordinator at the Institute on Digital Health and Innovation at Florida State University, Tallahassee, Florida, USA. Bryce F. Stamp, MPH, is a PhD student in the Department of Epidemiology at the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. Lisa Hightow-Weidman, MD, MPH, is a Professor, Associate Dean for Research, and Founding Director of the Institute on Digital Health and Innovation at Florida State University, Tallahassee, Florida, USA. Kimberly A. Powers, PhD, MSPH, is an Associate Professor of Epidemiology at the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. Jacob Benjamin Stocks, MSc-GH, is a Program Manager at the Institute on Digital Health and Innovation at Florida State University, Tallahassee, Florida, USA. Sybil Hosek, PhD, is a Clinical Psychologist and HIV Researcher in the Department of Psychiatry and the Division of Infectious Disease at Stroger Hospital of Cook County, and an Associate Professor in the Department of Medicine at Rush University, Chicago, Illinois, USA. Keith J. Horvath, PhD, is a Professor in the Department of Psychology at San Diego State University, San Diego, California, USA.

PMID: 39208418
DOI: 10.1097/JNC.0000000000000489

Abstract

This study quantitatively examined factors related to young men who have sex with men (YMSM)'s decisions to use pre-exposure prophylaxis (PrEP) by their history of PrEP use and qualitatively elicited their perspectives on PrEP options. Higher proportions of YMSM who had never used (vs. ever used) PrEP considered the following factors as important in their decisions to use PrEP: (a) Returning to PrEP follow-up visits (p = .02), (b) having to talk about sex/PrEP with providers (p = .013), (c) people assuming they are infected with HIV (p = .021), (d) family finding out about their PrEP use (p = .001), and (e) friends finding out about their PrEP use (p = .008). Through inductive content analysis, qualitative data showed that a higher proportion of YMSM who had never used PrEP (vs. ever used) expressed concerns about HIV stigma from nonaffirming health care providers and the potential risk of inadvertently revealing their LGBTQ+ identity to others, which were described as potential barriers to PrEP use. Overall, our findings suggest that future interventions may consider tailoring PrEP messaging to YMSM's history of PrEP use, which may ultimately increase PrEP uptake and adherence.

Grants and funding

R21 MH124678/MH/NIMH NIH HHS/United States