Cargando…

“What other choices might I have made?”: Sexual Minority Men, the PrEP Cascade and the Shifting Subjective Dimensions of HIV Risk

The PrEP Cascade is a dominant framework for investigating barriers to HIV pre-exposure prophylaxis (PrEP), an HIV prevention tool. We interviewed 37 PrEP users and 8 non-PrEP users in Ontario and British Columbia, Canada, about their decision-making through the Cascade. Participants were HIV-negati...

Descripción completa

Detalles Bibliográficos
Autores principales: Gaspar, Mark, Wells, Alex, Hull, Mark, Tan, Darrell H. S., Lachowsky, Nathan, Grace, Daniel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9350448/
https://www.ncbi.nlm.nih.gov/pubmed/35616240
http://dx.doi.org/10.1177/10497323221092701
_version_ 1784762216900198400
author Gaspar, Mark
Wells, Alex
Hull, Mark
Tan, Darrell H. S.
Lachowsky, Nathan
Grace, Daniel
author_facet Gaspar, Mark
Wells, Alex
Hull, Mark
Tan, Darrell H. S.
Lachowsky, Nathan
Grace, Daniel
author_sort Gaspar, Mark
collection PubMed
description The PrEP Cascade is a dominant framework for investigating barriers to HIV pre-exposure prophylaxis (PrEP), an HIV prevention tool. We interviewed 37 PrEP users and 8 non-PrEP users in Ontario and British Columbia, Canada, about their decision-making through the Cascade. Participants were HIV-negative gay, bisexual, and queer men (GBQM). The data were analyzed using thematic analysis. PrEP decision-making was based on pragmatic considerations (logistics, costs, and systemic barriers), biomedical considerations (efficacy, side-effects, and sexually transmitted infections), and subjective considerations (identity, politics, and changing sexual preferences). Affective attachments to established versions of “safer sex” (condoms and serosorting) made some GBQM less likely to try PrEP. Some GBQM expressed increased social expectations to use PrEP, have condomless sex, and serodifferent sex. These findings support offering PrEP at no-cost, offering individualized counseling and community-based opportunities to discuss PrEP use and changing sexual practices, and improving communication on the manageability of PrEP side-effects.
format Online
Article
Text
id pubmed-9350448
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-93504482022-08-05 “What other choices might I have made?”: Sexual Minority Men, the PrEP Cascade and the Shifting Subjective Dimensions of HIV Risk Gaspar, Mark Wells, Alex Hull, Mark Tan, Darrell H. S. Lachowsky, Nathan Grace, Daniel Qual Health Res Research Articles The PrEP Cascade is a dominant framework for investigating barriers to HIV pre-exposure prophylaxis (PrEP), an HIV prevention tool. We interviewed 37 PrEP users and 8 non-PrEP users in Ontario and British Columbia, Canada, about their decision-making through the Cascade. Participants were HIV-negative gay, bisexual, and queer men (GBQM). The data were analyzed using thematic analysis. PrEP decision-making was based on pragmatic considerations (logistics, costs, and systemic barriers), biomedical considerations (efficacy, side-effects, and sexually transmitted infections), and subjective considerations (identity, politics, and changing sexual preferences). Affective attachments to established versions of “safer sex” (condoms and serosorting) made some GBQM less likely to try PrEP. Some GBQM expressed increased social expectations to use PrEP, have condomless sex, and serodifferent sex. These findings support offering PrEP at no-cost, offering individualized counseling and community-based opportunities to discuss PrEP use and changing sexual practices, and improving communication on the manageability of PrEP side-effects. SAGE Publications 2022-05-26 2022-07 /pmc/articles/PMC9350448/ /pubmed/35616240 http://dx.doi.org/10.1177/10497323221092701 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Research Articles
Gaspar, Mark
Wells, Alex
Hull, Mark
Tan, Darrell H. S.
Lachowsky, Nathan
Grace, Daniel
“What other choices might I have made?”: Sexual Minority Men, the PrEP Cascade and the Shifting Subjective Dimensions of HIV Risk
title “What other choices might I have made?”: Sexual Minority Men, the PrEP Cascade and the Shifting Subjective Dimensions of HIV Risk
title_full “What other choices might I have made?”: Sexual Minority Men, the PrEP Cascade and the Shifting Subjective Dimensions of HIV Risk
title_fullStr “What other choices might I have made?”: Sexual Minority Men, the PrEP Cascade and the Shifting Subjective Dimensions of HIV Risk
title_full_unstemmed “What other choices might I have made?”: Sexual Minority Men, the PrEP Cascade and the Shifting Subjective Dimensions of HIV Risk
title_short “What other choices might I have made?”: Sexual Minority Men, the PrEP Cascade and the Shifting Subjective Dimensions of HIV Risk
title_sort “what other choices might i have made?”: sexual minority men, the prep cascade and the shifting subjective dimensions of hiv risk
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9350448/
https://www.ncbi.nlm.nih.gov/pubmed/35616240
http://dx.doi.org/10.1177/10497323221092701
work_keys_str_mv AT gasparmark whatotherchoicesmightihavemadesexualminoritymentheprepcascadeandtheshiftingsubjectivedimensionsofhivrisk
AT wellsalex whatotherchoicesmightihavemadesexualminoritymentheprepcascadeandtheshiftingsubjectivedimensionsofhivrisk
AT hullmark whatotherchoicesmightihavemadesexualminoritymentheprepcascadeandtheshiftingsubjectivedimensionsofhivrisk
AT tandarrellhs whatotherchoicesmightihavemadesexualminoritymentheprepcascadeandtheshiftingsubjectivedimensionsofhivrisk
AT lachowskynathan whatotherchoicesmightihavemadesexualminoritymentheprepcascadeandtheshiftingsubjectivedimensionsofhivrisk
AT gracedaniel whatotherchoicesmightihavemadesexualminoritymentheprepcascadeandtheshiftingsubjectivedimensionsofhivrisk