Barriers to Access and Adoption of Pre-Exposure Prophylaxis for the Prevention of HIV Among Men Who Have Sex With Men (MSM) in a Relatively Rural State

Hubach, Randolph D.; Currin, Joseph M.; Sanders, Carissa; Durham, André R.; Kavanaugh, Katherine E.; Wheeler, Denna L.; Croff, Julie M.

doi:10.1521/aeap.2017.29.4.315

Cited by 92 publications

(75 citation statements)

References 56 publications

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“…However, other studies have identified the need for improved health care access as a barrier to PrEP uptake among high risk individuals. 55,56 Unfortunately, these issues are longstanding, and it is unlikely that disparities in health care access will be overcome in the near term. Demonstration projects evaluating alternative strategies to increase demand and accelerate uptake of PrEP that utilize novel approaches such as pharmacy access and online purchasing are underway.…”

Section: Discussionmentioning

confidence: 99%

Facilitators and Barriers to Pre-Exposure Prophylaxis (PrEP) Use Among Black Individuals in the United States: Results from the National Survey on HIV in the Black Community (NSHBC)

et al. 2018

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This study explores willingness to use PrEP among Black individuals in the US. From February to April 2016, an online survey was administered to a nationally representative sample of Black individuals. 855 individuals who were HIV negative by self-report participated [mean age: 33.6 (SD 9.2); 45.5% male]. Among all respondents, 14.5% were aware of, and 26.0% would be willing to use PrEP. Among high-risk individuals (N = 327), 19.8% knew about and 35.1% would be willing to use PrEP. The most common reason for lack of willingness among high-risk individuals was low self-perceived risk (65.1%). In multivariate analysis, individuals reporting single marital status [OR 1.8 (1.2, 2.5), p = 0.002], depressive symptoms [OR 1.6 (1.2, 2.2), p = 0.0054], arrest history [OR 1.7(1.2, 2.4), p = 0.0003], PrEP knowledge [OR 1.5 (1.0, 2.3), p = 0.0247] and belief in HIV conspiracies [OR 1.3 (1.1, 1.5), p = 0.0075] were more willing to use PrEP. Participants who saw a health care provider less frequently were less willing to use PrEP [OR 0.5 (0.4, 0.8), p = 0.0044]. Among a nationally representative sample of Black individuals, few high risk individuals were willing to use PrEP. Interventions to increase risk awareness, PrEP knowledge and access to care are necessary to improve PrEP uptake.

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Section: Discussionmentioning

confidence: 99%

Facilitators and Barriers to Pre-Exposure Prophylaxis (PrEP) Use Among Black Individuals in the United States: Results from the National Survey on HIV in the Black Community (NSHBC)

et al. 2018

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“…Many factors seem to play a role in heightened levels of willingness or interest in PrEP, especially if one is in a serodiscordant relationship (Brooks et al, 2012;Hoff et al, 2015;Kubicek, Arauz-Cuadra, & Kipke, 2015;Kuhns, Hotton, Schneider, Garofalo, & Fujimoto, 2017). Lack of interest or unwillingness to use PrEP appears to be associated with concerns about side effects (Goedel et al, 2016;Mutchler et al, 2015), lack of knowledge (Goedel et al, 2016), perceived inaccessibility and unaffordability (Calabrese et al, 2016;Goedel et al, 2016;Hubach et al, 2017;Kubicek et al, 2015;Oldenburg et al, 2016;Pérez-Figueroa et al, 2015;Whitfield, John, Rendina, Grov, & Parsons, 2018), perceived stigma (Franks et al, 2018;Hubach et al, 2017;Kubicek et al, 2015;Mutchler et al, 2015;Pérez-Figueroa et al, 2015;Young, Flowers, & McDaid, 2016), and 1 3 the perception that PrEP will lead to reduced condom use and greater sexual risk behavior (Eaton et al, 2017b;Grov, Rendina, Whitfield, Ventuneac, & Parsons, 2016;Hoff et al, 2015;Kubicek et al, 2015;Oldenburg et al, 2016;Pérez-Figueroa et al, 2015). Research has begun to document positive changes to sex and sexual culture some men on PrEP identify, such as more direct communication about HIV (Hannaford et al, 2018), reduced stigma against HIV-positive partners (Storholm, Volk, Marcus, Silverberg, & Satre, 2017), and reduced anxiety associated with sex (Brooks et al, 2012;Hojilla et al, 2016;Kwakwa et al, 2016;Storholm et al, 2017)...…”

Section: Prep Public Health and Sexual Culturementioning

confidence: 99%

Making Meaning of the Impact of Pre-Exposure Prophylaxis (PrEP) on Public Health and Sexual Culture: Narratives of Three Generations of Gay and Bisexual Men

et al. 2019

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Pre-exposure prophylaxis (PrEP) with Truvada has emerged as an increasingly common approach to HIV prevention among gay, bisexual, and other men who have sex with men. This study examined generational differences and similarities in narrative accounts of PrEP among a diverse sample of 89 gay and bisexual men in the U.S. Over 50% of men in the older (52-59 years) and younger (18-25 years) generations endorsed positive views, compared with 32% of men in the middle (34-41 years) generation. Men in the middle cohort expressed the most negative (21%) and ambivalent (47%) views of PrEP. Thematic analysis of men's narratives revealed three central stories about the perceived impact of PrEP: (1) PrEP has a positive impact on public health by preventing HIV transmission (endorsed more frequently by men in the older and younger cohorts); (2) PrEP has a positive effect on gay and bisexual men's sexual culture by decreasing anxiety and making sex more enjoyable (endorsed more frequently by men in the middle and younger cohorts); and (3) PrEP has a negative impact on public health and sexual culture by increasing condomless, multi-partner sex (endorsed more frequently by men in the middle and younger cohorts). Results are discussed in terms of the significance of generation cohort in meanings of sexual health and culture and implications for public health approaches to PrEP promotion among gay and bisexual men.

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“…To begin treatment, however, individuals must be aware of their HIV status. Specific efforts to educate rural primary care providers regarding these and other clinical methods of HIV prevention are needed …”

Section: Discussionmentioning

confidence: 99%

“…Specific efforts to educate rural primary care providers regarding these and other clinical methods of HIV prevention are needed. [73][74][75]…”

Section: Knowledge Variability Across Content Areasmentioning

confidence: 99%

Rural Primary Care Providers’ Experiences and Knowledge Regarding LGBTQ Health in a Midwestern State

Shaver

Sharma

Stephenson

2018

The Journal of Rural Health

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Barriers to Access and Adoption of Pre-Exposure Prophylaxis for the Prevention of HIV Among Men Who Have Sex With Men (MSM) in a Relatively Rural State

Cited by 92 publications

References 56 publications

Facilitators and Barriers to Pre-Exposure Prophylaxis (PrEP) Use Among Black Individuals in the United States: Results from the National Survey on HIV in the Black Community (NSHBC)

Facilitators and Barriers to Pre-Exposure Prophylaxis (PrEP) Use Among Black Individuals in the United States: Results from the National Survey on HIV in the Black Community (NSHBC)

Making Meaning of the Impact of Pre-Exposure Prophylaxis (PrEP) on Public Health and Sexual Culture: Narratives of Three Generations of Gay and Bisexual Men

Rural Primary Care Providers’ Experiences and Knowledge Regarding LGBTQ Health in a Midwestern State

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