Rural men who have sex with men (MSM) experience numerous barriers to healthcare, including stigma, which impedes medical and mental healthcare engagement. Given this, rural MSM are less likely to be engaged in routine healthcare compared to their urban counterparts. Telemedicine has been advocated for to address these disparities in care access; however, no known studies have explored the amenability of telemedicine for both medical and mental healthcare among rural MSM. In-depth interviews were conducted with a sample of MSM (n = 23) residing in rural Oklahoma and Arkansas. Respondents described a willingness to use telemedicine to engage with medical and mental health providers as it presented a mechanism to overcome identified barriers to care. Removing barriers, notably lack of access to knowledgeable and affirming providers, is one potential method for increasing engagement in routine care which provides opportunities for rural MSM to engage in primary and secondary prevention services.
Pre-exposure prophylaxis (PrEP) uptake has been suboptimal despite its demonstrated efficacy in reducing the risk of HIV acquisition. Medical education is one distal determinant that shapes medical providers’ perceived role in the PrEP care continuum. However, there is limited understanding of how osteopathic medical students and those wanting to practice in rural areas perceive their role in the PrEP care continuum in the domains of PrEP awareness, uptake, and adherence and retention. Twenty-one semistructured interviews were conducted (March 2019–April 2020) to assess what shapes osteopathic medical students’ perceived role in the PrEP care continuum. Participants noted a lack of adequate sexual health training, personal perceptions concerning PrEP use, and ambiguity concerning which of the medical specialties should deliver PrEP. Osteopathic medical schools can incorporate more inclusive and holistic sexual health and PrEP curricula to address these barriers and better prepare osteopathic medical students for their future role in the PrEP care continuum.
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