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“That’s kind of like the big struggle right now is can we get PrEP?”: Facilitators and Barriers to PrEP Uptake Among Active Duty Gay and Bisexual Men

INTRODUCTION: The US Military is experiencing a rise in HIV infections among gay and bisexual men (GBM) serving on active duty, yet little is known about this population’s uptake of pre-exposure prophylaxis (PrEP), an evidence-based intervention for HIV prevention. This mixed methods study examines...

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Detalles Bibliográficos
Autores principales: Beltran, Raiza M., Schuyler, Ashley C., Blair, Cherie S., Goldbach, Jeremy T., Castro, Carl A., Holloway, Ian W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10212805/
https://www.ncbi.nlm.nih.gov/pubmed/37250806
http://dx.doi.org/10.1007/s13178-021-00622-6
Descripción
Sumario:INTRODUCTION: The US Military is experiencing a rise in HIV infections among gay and bisexual men (GBM) serving on active duty, yet little is known about this population’s uptake of pre-exposure prophylaxis (PrEP), an evidence-based intervention for HIV prevention. This mixed methods study examines the facilitators and barriers to PrEP access and uptake among active duty GBM. METHODS: Active duty GBM were recruited using respondent-driven sampling (2017 and 2018). Participants (n = 93) answered quantitative survey questions on PrEP interest and accessibility. Another set of participants (n = 10) discussed their PrEP experiences in qualitative interviews. We conducted descriptive and bivariate analyses of quantitative data, while qualitative data were analyzed using structural and descriptive coding techniques. RESULTS: Approximately 71% of active duty GBM indicated interest in accessing PrEP. A greater proportion of those who disclosed (vs. did not disclose) their sexual orientation to their military doctor discussed (p < 0.001) or accessed (p = 0.017) PrEP. The following qualitative themes emerged: (1) providers’ negative views and knowledge gaps related to PrEP; (2) lack of a systems approach to PrEP access; (3) confidentiality concerns; and (4) reliance on peer networks for PrEP guidance and support. CONCLUSIONS: Study results indicate that active duty GBM are interested in and want to discuss PrEP with their military doctors, but gaps in providers’ PrEP-related knowledge and skills, as well as mistrust in the military health care system, remain. POLICY IMPLICATIONS: A system-wide approach that addresses confidentiality concerns and removes procedural barriers to PrEP access is recommended to improve PrEP uptake in this population.