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Social, structural, behavioral and clinical factors influencing retention in Pre-Exposure Prophylaxis (PrEP) care in Mississippi

Pre-exposure prophylaxis (PrEP) is a biomedical intervention that can reduce rates of HIV transmission when taken once daily by HIV-negative individuals. Little is understood about PrEP uptake and retention in care among the populations most heavily impacted by the HIV epidemic, particularly among y...

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Autores principales: Arnold, Trisha, Brinkley-Rubinstein, Lauren, Chan, Philip A., Perez-Brumer, Amaya, Bologna, Estefany S., Beauchamps, Laura, Johnson, Kendra, Mena, Leandro, Nunn, Amy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319650/
https://www.ncbi.nlm.nih.gov/pubmed/28222118
http://dx.doi.org/10.1371/journal.pone.0172354
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author Arnold, Trisha
Brinkley-Rubinstein, Lauren
Chan, Philip A.
Perez-Brumer, Amaya
Bologna, Estefany S.
Beauchamps, Laura
Johnson, Kendra
Mena, Leandro
Nunn, Amy
author_facet Arnold, Trisha
Brinkley-Rubinstein, Lauren
Chan, Philip A.
Perez-Brumer, Amaya
Bologna, Estefany S.
Beauchamps, Laura
Johnson, Kendra
Mena, Leandro
Nunn, Amy
author_sort Arnold, Trisha
collection PubMed
description Pre-exposure prophylaxis (PrEP) is a biomedical intervention that can reduce rates of HIV transmission when taken once daily by HIV-negative individuals. Little is understood about PrEP uptake and retention in care among the populations most heavily impacted by the HIV epidemic, particularly among young men who have sex with men (YMSM) in the Deep South. Therefore, this study explored the structural, social, behavioral, and clinical factors that affect PrEP use and retention in care among YMSM in Jackson, Mississippi. Thirty MSM who were prescribed PrEP at an outpatient primary care clinic were interviewed and included 23 men who had been retained in PrEP care and seven who had not been retained. The mean age of participants was 26.6 years. Most (23) participants were African American. Major factors affecting PrEP use and retention in PrEP care included 1) structural factors such as cost and access to financial assistance for medications and clinical services; 2) social factors such as stigma and relationship status; 3) behavioral factors including sexual risk behaviors; and 4) clinical factors such as perceived and actual side effects. Many participants also discussed the positive spillover effects of PrEP use and reported that PrEP had a positive impact on their health. Four of the seven individuals who had not been retained re-enrolled in PrEP care after completing their interviews, suggesting that case management and ongoing outreach can enhance retention in PrEP care. Interventions to enhance retention in PrEP care among MSM in the Deep South will be most effective if they address the complex structural, social, clinical, and behavioral factors that influence PrEP uptake and retention in PrEP care.
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spelling pubmed-53196502017-03-03 Social, structural, behavioral and clinical factors influencing retention in Pre-Exposure Prophylaxis (PrEP) care in Mississippi Arnold, Trisha Brinkley-Rubinstein, Lauren Chan, Philip A. Perez-Brumer, Amaya Bologna, Estefany S. Beauchamps, Laura Johnson, Kendra Mena, Leandro Nunn, Amy PLoS One Research Article Pre-exposure prophylaxis (PrEP) is a biomedical intervention that can reduce rates of HIV transmission when taken once daily by HIV-negative individuals. Little is understood about PrEP uptake and retention in care among the populations most heavily impacted by the HIV epidemic, particularly among young men who have sex with men (YMSM) in the Deep South. Therefore, this study explored the structural, social, behavioral, and clinical factors that affect PrEP use and retention in care among YMSM in Jackson, Mississippi. Thirty MSM who were prescribed PrEP at an outpatient primary care clinic were interviewed and included 23 men who had been retained in PrEP care and seven who had not been retained. The mean age of participants was 26.6 years. Most (23) participants were African American. Major factors affecting PrEP use and retention in PrEP care included 1) structural factors such as cost and access to financial assistance for medications and clinical services; 2) social factors such as stigma and relationship status; 3) behavioral factors including sexual risk behaviors; and 4) clinical factors such as perceived and actual side effects. Many participants also discussed the positive spillover effects of PrEP use and reported that PrEP had a positive impact on their health. Four of the seven individuals who had not been retained re-enrolled in PrEP care after completing their interviews, suggesting that case management and ongoing outreach can enhance retention in PrEP care. Interventions to enhance retention in PrEP care among MSM in the Deep South will be most effective if they address the complex structural, social, clinical, and behavioral factors that influence PrEP uptake and retention in PrEP care. Public Library of Science 2017-02-21 /pmc/articles/PMC5319650/ /pubmed/28222118 http://dx.doi.org/10.1371/journal.pone.0172354 Text en © 2017 Arnold et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Arnold, Trisha
Brinkley-Rubinstein, Lauren
Chan, Philip A.
Perez-Brumer, Amaya
Bologna, Estefany S.
Beauchamps, Laura
Johnson, Kendra
Mena, Leandro
Nunn, Amy
Social, structural, behavioral and clinical factors influencing retention in Pre-Exposure Prophylaxis (PrEP) care in Mississippi
title Social, structural, behavioral and clinical factors influencing retention in Pre-Exposure Prophylaxis (PrEP) care in Mississippi
title_full Social, structural, behavioral and clinical factors influencing retention in Pre-Exposure Prophylaxis (PrEP) care in Mississippi
title_fullStr Social, structural, behavioral and clinical factors influencing retention in Pre-Exposure Prophylaxis (PrEP) care in Mississippi
title_full_unstemmed Social, structural, behavioral and clinical factors influencing retention in Pre-Exposure Prophylaxis (PrEP) care in Mississippi
title_short Social, structural, behavioral and clinical factors influencing retention in Pre-Exposure Prophylaxis (PrEP) care in Mississippi
title_sort social, structural, behavioral and clinical factors influencing retention in pre-exposure prophylaxis (prep) care in mississippi
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319650/
https://www.ncbi.nlm.nih.gov/pubmed/28222118
http://dx.doi.org/10.1371/journal.pone.0172354
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