Abstract
PurposeMen who have sex with men (MSM) who are incarcerated are at increased risk for HIV acquisition, yet there are challenges associated with disclosing sexual identity/orientation among people who are incarcerated.MethodsThe current study used semi-structured, qualitative interviews to explore attitudes and awareness of pre-exposure prophylaxis (PrEP) among 26 MSM who were incarcerated at the Rhode Island Department of Corrections.ResultsParticipants noted variable levels of willingness to disclose sexual identity/orientation.ConclusionsCJ institutions should consider involving medical staff and outside agencies when using the CDC PrEP guidelines or consider a WHO-based, rather than behavior-based, approach to determining candidacy for PrEP.
Highlights
Men who have sex with men (MSM) who are incarcerated are at increased risk for HIV acquisition, yet there are challenges associated with disclosing sexual identity/orientation among people who are incarcerated
criminal justice (CJ) populations have a prevalence of HIV that is three times that of the general population making individuals who are in the CJ system at substantive risk, regardless of risk behaviors (Maruschak, 2012)
Four categories of disclosure We found that incarcerated MSM fell into four disclosure categories: 1) those who wanted to disclose their sexual orientation/identity and were not concerned about others finding out; 2) those who were willing to disclose but only to certain individuals; 3) those who did not want to disclose their sexual orientation/identity, but felt they had no choice
Summary
Men who have sex with men (MSM) who are incarcerated are at increased risk for HIV acquisition, yet there are challenges associated with disclosing sexual identity/orientation among people who are incarcerated. Men who have sex with men (MSM) are at increased risk for criminal justice (CJ) involvement and acquiring HIV (Lim et al, 2011; Beyrer et al, 2012) The incarceration rate of sexual minorities is three times that of the general population (Meyer et al, 2017). Identifying MSM in jails and prisons is challenging given the concerns Both the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) have recommendations for use of PrEP. We outline 1) four categories that characterize incarcerated MSM’s sexual orientation/identity disclosure practices; 2) suggestions for optimizing PrEP eligibility screening based on CDC guidelines; and 3) consideration of the adoption of screening based on the WHO’s definition of substantive risk
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