Abstract
Black men who have sex with men (BMSM) have higher HIV incidence and prevalence when compared to other MSM, despite similar levels of condom use and testing. Pre-exposure prophylaxis (PrEP) could be a useful intervention to reduce these inequalities. This research therefore aims to understand the dimensions of acceptability of a potential PrEP service for BMSM aged 18-45 years in London. In-depth semi-structured interviews were conducted with 25 PrEP-eligible BMSM between April and August 2016. Interviews were recorded and transcribed verbatim, then subject to a thematic framework analysis, informed by intersectionality theory. BMSM had distinct preferences for sexual health services, which have implications for PrEP service development. Three primary domains emerged in our analysis: proximity and anonymity; quality, efficiency and reassurance; and understanding, empathy and identity. These relate, respectively, to preferences regarding clinic location and divisions from community, features of service delivery and staff characteristics. Due to concerns about confidentiality, community-based services may not be useful for this group. Careful consideration in regards to components used in service development will facilitate ongoing engagement. Interpersonal skills of staff are central to service acceptability, particularly when staff are perceived to be from similar cultural backgrounds as their patients.
Highlights
Black men who have sex with men (BMSM) have higher HIV incidence and prevalence when compared to other MSM, despite similar levels of condom use and testing
Given that Pre-exposure prophylaxis (PrEP) requires on-going clinical engagement, this study focuses on elements of service development that might help retain individuals in care
We recruited 25 BMSM who varied in ethnicity, age, educational attainment and previous use of health services and experiences of PrEP
Summary
Black men who have sex with men (BMSM) have higher HIV incidence and prevalence when compared to other MSM, despite similar levels of condom use and testing. Clinical trials and modelling evidence have demonstrated that the provision of antiretroviral HIV medications to HIV-negative individuals can be highly effective in reducing HIV acquisition and can reduce costs to the health service.[1,2,3,4,5,6] In England, the PROUD study reported a reduction of 86% in new infections among men who have sex with men (MSM) allocated to the group who were given immediate access to PrEP.[2]. MSM have the highest HIV incidence of all groups in England, further health inequalities exist.[9,10,11] Recent cross-sectional and systematic review evidence indicates that black MSM (BMSM) have higher HIV incidence than other MSM despite similar rates of condom use and of HIV testing.[10,11,12] Further, HIV incidence peaks in MSM between the ages of 18 and 45, indicating that this group could most benefit from PrEP.[9,13]. The provision of PrEP challenges this model and makes longer term engagement crucial for effective follow-up
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
