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“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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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SAGE Publications
2022
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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 |
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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 |
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