Introduction Latino sexual minority men (SMM) represent 26% of new HIV diagnoses among sexual minority men, with lower PrEP utilization rates despite its effectiveness. Provider perceptions play a crucial role in effective PrEP delivery, necessitating coordination with Latino SMM. Methods We interviewed 10 providers from an LGBTQ health center in a major city using convenience sampling via clinic administrator emails until saturation. Interviews, conducted over Zoom, lasting 45–60 minutes. Data analysis was performed using NVivo, employing thematic analysis based on Levesque’s healthcare access dimensions, along with cross-case analysis and analytical coding. Results Appropriateness and acceptability of services were the most salient topics discussed. Respondents reported inconsistent language accommodations for the Spanish speaking population, while others reported the utilization of an interpreter line. Participants commented on issues with the cultural representation across all departments at the clinic. Providers also noted specific barriers to care among Latino SMM, such as a lack of Latino representation in clinical and health care coordination positions. Conclusion Our study focused on provider perceptions of engaging Latino SMM. Findings highlight the significance of service appropriateness and acceptability, suggesting that cultural preferences and service adequacy may play a larger role in PrEP access for Latino SMM than traditional barriers like affordability and availability.

PrEP uptake and continuation among women in sub-Saharan Africa, including adolescent girls, young women (AGYW), and female sex workers (FSW), remains suboptimal. Societal costs, like lost wages and time, are potential barriers. This study assessed the time and resources spent by patients and provider for PrEP-related care including HIV testing, STI screening, PrEP counseling, and prescription management of PrEP among AGYW and FSW in South Africa, exploring factors that may affect PrEP uptake and continuation. We conducted a cross-sectional time and motion study, representing a quantitative method used to assess the duration required to complete a defined series of tasks, at 13 decentralized PrEP service sites across nine districts in South Africa. The study measured time spent by clients (AGYW and FSW) receiving PrEP services and by healthcare providers delivering care. Wilcoxon rank-sum tests compared service durations, and opportunity costs (wages lost due to time receiving PrEP services) were estimated for all FSW. The study included 148 participants (40% AGYW, 60% FSW). The median time for PrEP services was 25min (IQR: 14-38). AGYW spent a median of 33min (IQR: 21-53.5), and FSW spent 22min (IQR: 13-33), (p = 0.0014). Time was longer for initiation visits (41min) than refill visits (20min) (p < 0.0001). Moreover, the median opportunity cost for FSW was 240 ZAR (IQR: 139-358). Lastly, providers spent 13.5-21min on initiations and 9-27min on refills. Despite free PrEP access, time and wage costs are significant barriers. Reducing the time commitments could enhance PrEP continuation for AGYW and FSW, though additional strategies for client support and counseling may be needed. Ultimately, improving the efficiency of PrEP delivery may boost PrEP continuation for marginalized women in South Africa.

Expanding PrEP Access Through Decentralized Delivery Models.

PrEP-eligible cisgender women underutilize PrEP, and little is known about how PrEP fits within broader HIV/STI prevention ecologies shaped by personal preferences and relationship contexts. These ecologies inform prevention strategies that shift with relationship dynamics and vary by race/ethnicity, age, and setting; the COVID-19 pandemic further influenced these contexts. Data were drawn from the Women's Study in Sexual Health and Empowerment (WISE), a mixed-methods study of PrEP-eligible cisgender women in New York City and Rochester, NY. One-time semi-structured interviews were conducted with 48 women from the WISE cohort. Women described tailoring prevention to relationship context, often initiating relationships with condoms and later relying more on trust and periodic HIV/STI testing. Strategies included situational condom use, combination prevention with PrEP and HIV/STI testing, and PrEP initiation or discontinuance as perceived risk changed. Women also reported challenges negotiating condom use, including partner resistance, and some described abstinence as a deliberate strategy. Comparative analyses identified patterns by race/ethnicity, age, and site. Pandemic-related disruptions reduced opportunities for new partnerships, altered relationship dynamics, and shifted some prevention conversations toward SARS-CoV-2 exposure risk. Findings highlight the need for women-centered, culturally and contextually tailored prevention services that strengthen PrEP access and routinized HIV/STI testing while accounting for relationship dynamics.

The Western region of the US has received comparatively less attention in HIV research despite housing several Ending the HIV Epidemic priority areas. Understanding HIV risk and prevention behaviors among men who have sex with men (MSM) in this region is critical. This study examines differences in HIV risk and prevention behaviors among MSM in the Pacific (CA, WA) and Mountain (AZ, NV) sub-regions. We conducted a serial cross-sectional analysis using 2017-2021 data from the American Men's Internet Survey. The sample included MSM with HIV-negative or unknown status. Key outcomes included condomless anal intercourse, substance use, STI diagnoses, HIV/STI testing, and PrEP awareness, willingness and use. Poisson regression models with robust standard errors estimated prevalence ratios and 95% confidence intervals, adjusting for sociodemographics. Among 7423 MSM, 81.3% resided in the Pacific sub-region, 53.0% were aged <30 years and 50.8% were white. Condomless anal intercourse rates were similar across sub-regions, but STI diagnoses (13.0% vs 10.1%, P<0.05) and substance use were higher in the Pacific compared with the Mountain sub-region. HIV testing (55.5% vs 59.8%, P<0.05) and STI testing (39.2% vs 45.7%, P<0.001) were lower in the Mountain sub-region compared with the Pacific sub-region. PrEP awareness was similar, but usage was lower (17.2% vs 23.1%, P<0.001) despite higher willingness (51.8% vs 44.5%, P<0.001) in the Mountain compared with the Pacific sub-region. HIV risk was similar across sub-regions, but disparities in prevention engagement highlight regional barriers. Expanding PrEP access and HIV/STI testing in the Mountain sub-region is critical to achieving Ending the HIV Epidemic goals.

Gay, bisexual, and other men who have sex with men (GBMSM) in the United States are disproportionately affected by the HIV epidemic. Long-acting injectable pre-exposure prophylaxis (LAI-PrEP) represents a novel HIV prevention strategy. However, stigma remains a barrier to HIV-related prevention and care. We investigated the role of intersectional stigma in LAI-PrEP preferences among past-year PrEP-naive, HIV-negative US cisgender GBMSM. The 2022 American Men's Internet Survey enrolled cisgender GBMSM online between October 2022 and October 2023. Using bivariate and multivariable adjusted Poisson regression with robust variance and a modified Intersectional Discrimination Index to examine associations between several forms of stigma-anticipated, day-to-day, social systems exclusion, and violence and harassment-and LAI-PrEP willingness and preference. Among participants (N = 1196), 705 (59.0%) were willing to use any PrEP modality and 393 (32.9%) were willing to use LAI-PrEP, among whom 211 (29.9%) reported a preference for LAI-PrEP. On average, participants experienced 1.8 of 7 anticipated discrimination items, 3.9 of 7 day-to-day discrimination items, 0.2 of 3 social systems exclusion items, and 0.9 of 4 violence/harassment items. Willingness to use LAI-PrEP was associated with anticipated stigma (adjusted prevalence ratio [aPR] = 1.06; 95% confidence interval [CI] = 1.02 to 1.10; P < 0.01). Preference for LAI-PrEP was associated with anticipated stigma (aPR = 1.06; 95% CI = 1.00 to 1.12; P = 0.04), day-to-day (aPR = 1.09; 95% CI = 1.02 to 1.15; P = 0.01) stigma, and violence/harassment (aPR = 1.09; 95% CI = 1.01 to 1.18; p-0.03). Given disproportionate HIV burden among GBMSM, a range of HIV PrEP modality options combined with efforts to address intersectional anticipated and enacted stigma among GBMSM is critical to ensure PrEP access, uptake, and adherence.

BackgroundGay, bisexual, and other men who have sex with men (GBMSM) in the United States (U.S.) are disproportionately impacted by the HIV epidemic. Long-acting injectable pre-exposure prophylaxis (LAI-PrEP) represents a novel HIV prevention strategy. However, stigma remains a known barrier to HIV-related prevention and care. We investigated the role of intersectional stigma (which manifests as discrimination) in LAI-PrEP preferences among U.S. cisgender GBMSM.MethodsThe 2022 American Men’s Internet Survey (AMIS) enrolled cisgender GBMSM online between October 2022 and October 2023. Analyses were restricted to participants randomized (50/50) to receive intersectional stigma questions who reported no prior HIV diagnosis or past year PrEP use and provided a valid willingness to use LAI-PrEP response. PrEP modality preference analyses were further restricted to participants who reported willingness to use at least one PrEP modality. Using bivariate and multivariable adjusted Poisson regression models with robust variance, we used a modified 21-item version of the Intersectional Discrimination Index to examine associations between several forms of stigma—anticipated, day-to-day, social systems exclusion, and violence and harassment—and LAI-PrEP willingness and preference.ResultsAmong participants (N=2314), 819 (35.4%) were willing to use any form of PrEP and (469 [20.3%] were willing to use LAI-PrEP), among whom 263 (32.1%) reported a preference for LAI-PrEP over other PrEP modalities. On average, participants experienced 1.8 of the 7 anticipated discrimination items, 4.1 of the 7 day-to-day discrimination items, 0.3 of the 3 social systems exclusion items, and 1.1 of the 4 violence/harassment items (Table 1). Willingness to use LAI-PrEP was associated with anticipated stigma (aPR=1.06; 95% CI=1.01-1.12; p=0.01). Preference for LAI-PrEP vs. oral PrEP modalities was associated with day-to-day stigma (aPR=1.07; 95% CI=1.01-1.13; p=0.02) (Table 2).ConclusionGiven disproportionate HIV burden among GBMSM, HIV PrEP modality options (e.g., LAI-PrEP), which respond to diverse stigma concerns, combined with efforts to address intersectional stigma, are critical to ensure PrEP access, uptake, and adherence among GBMSM.DisclosuresTravis Sanchez, DVM, MPH, ViiV Healthcare, Inc.: Grant/Research Support Supriya Sarkar, PhD, MPH, ViiV Healthcare: Stocks/Bonds (Public Company) Leigh Ragone, MS, GSK: Stocks/Bonds (Private Company)|ViiV Healthcare: Employee Vani Vannappagari, MBBS, MPH, PhD, ViiV Healthcare: Full time Employee of ViiV Healthcare and owns GSK stock|ViiV Healthcare: Stocks/Bonds (Public Company)

BackgroundGeorgia remains heavily impacted by HIV, particularly among Black and Latino communities. HIV molecular epidemiology (HME) uses HIV pol gene sequence similarity to detect rapidly transmitting networks in near real time, supporting timely public health response and resource allocation. However, integration of behavioral, sociodemographic, and network-level dynamics into HME-informed interventions remains limited. To address this, we developed epidemiologic profiles of five HIV molecular networks in Georgia and applied a multi-level framework to guide equitable, data-driven public health action.Table 1.Demographic, Behavioral, Structural, and Prior STI Characteristics of Individuals in Five HIV Molecular Networks in Georgia.MSM = Men who have sex with men. IDU = Injection drug use. SVI = Social Vulnerability Index (range: 0–1), matched to eHARS data by census tract at time of HIV diagnosis, with higher values indicating greater community-level vulnerability. “Anonymous Sex”: refers to sexual activity with a partner whose identity is unknown. “Drug-associated sex” refers to sex with a partner who injects drugs, sex exchanged for drugs, or sex under the influence of injection drug use. “STI Before HIV” indicates individuals with a documented STI diagnosis prior to their HIV diagnosis. Median and range reflect the number of years between earliest recorded STI and HIV diagnosis.Table 2.Care Continuum Outcomes Among Individuals in Five HIV Molecular Networks in Georgia.Care engagement and retention were assessed using HIV viral load data from surveillance systems. Individuals were considered engaged if they had ≥1 lab in the past 12 months and retained if they had ≥2 labs ≥3 months apart. Viral suppression was defined as the most recent viral load <200 copies/mL.MethodsWe analyzed five molecular networks using 2024 surveillance data from the Georgia Department of Public Health, including HIV-TRACE (molecular data), eHARS (HIV surveillance), and SendSS (Georgia’s notifiable disease reporting). We examined demographic, clinical, behavioral, and structural characteristics, including Social Vulnerability Index (SVI) scores. Data from 31 named partners were also assessed to identify prevention gaps.Table 3.Demographic and Clinical Characteristics of Named Partners Linked to Five HIV Molecular Networks in Georgia.Data represents 31 individuals named through partner services associated with network members. HIV status reflects the most recent available surveillance data. “Interview” indicates whether named partners participated in interviews. “On PrEP” use was based on recorded referral or reported uptake.Table 4.Opportunities for Intervention at the Individual, Network, and Systems Levels Based on Findings from Five HIV Molecular Networks and Named Partners in Georgia.ResultsAmong 104 individuals across five networks (range: 4–67), profiles varied by composition and risk (Table 1). Network A included 43% Latino men (median age 30, SVI 0.53); Network D was mostly (72%) young Black women (median age 21, SVI 0.74) with high behavioral risk (56% drug-associated sex, 28% intoxicated sex, 22% anonymous sex). Over 99% of records lacked key behavioral data, including substance use and PrEP linkage. Prior STIs were recorded in 27%, with a median lead time of 2–4 years before HIV diagnosis. Care engagement ranged from 67–90%, with lower retention and viral suppression in higher-SVI networks (Table 2). Among named partners, 36% were HIV-positive, 42% had unknown status, only 23% were interviewed by health departments, and none were on PrEP (Table 3).ConclusionFindings highlight missed opportunities for prevention and care in fast-growing networks. We propose a multi-level response framework (Table 4) aligned with CDC guidance to improve PrEP access, retention, partner services, and data integration.DisclosuresAll Authors: No reported disclosures

BackgroundDrug use and HIV pose a public health challenge in the Dominican Republic (DR), where stigma and limited healthcare access increase risks for PWUD. This study assesses HIV seroprevalence, STIs, and healthcare engagement to inform targeted interventions.MethodsA cross-sectional study was conducted in five Dominican provinces using respondent-driven sampling to recruit PWUD aged ≥18 who reported drug use in the past six months. Structured interviews collected demographic, behavioral, and healthcare data, while biological samples were tested for HIV, syphilis, HBV, and HCV. HIV-positive individuals were assessed for awareness, ART history, and care engagement.ResultsA total of 2,155 PWUD were recruited across study sites. Most participants were male, with a median age of 36 years (IQR: 30–41). Among respondents, 78% (95% CI: 76.3%–79.7%) reported inconsistent condom use in the past six months. Regarding self-reported sexual orientation, 42% identified as bisexual. The seroprevalence of HIV was 4.0%, while syphilis, HCV, and HBV rates were 11.5%, 1.2%, and 2.7%, respectively. Among PWH, 67% (95% CI: 65.0%–69.0%) engaged in transactional sex for money, goods, or services. Only 16.7% (95% CI: 15.1%–18.3%) had ever initiated ART, and 14.3% (95% CI: 12.8%–15.8%) reported current ART use. Notably, 74% (95% CI: 72.1%–75.9%) of PWUD with prior ART experience had discontinued treatment. Engagement with biomedical HIV prevention strategies was minimal. Only 6.7% (95% CI: 5.6%–7.8%) of PWUD had heard of PrEP, while 3.8% (95% CI: 3.0%–4.6%) had ever used it. PrEP persistence was even lower, with just 2.6% (95% CI: 1.9%–3.3%) reporting use in the past six months.ConclusionFindings highlight critical gaps in HIV prevention and care, emphasizing the need for integrated, evidence-based interventions. Expanding PrEP access through harm reduction services, strengthening ART adherence through peer-led models, and integrating harm reduction into national HIV strategies are essential. Addressing stigma and criminalization via policy reforms and scaling up HIV/STI testing and linkage-to-care models is crucial. These findings provide evidence to inform policy and programmatic interventions, supporting global HIV epidemic control.DisclosuresAll Authors: No reported disclosures

ABSTRACT We conducted a participatory workshop with pregnant or parenting young women to co-create innovative PrEP delivery strategies informed by their lived experiences. Nine pregnant or parenting young women (n = 6 aged 18–24; n = 3 aged 25–28) were recruited from the FastPrEP study, an implementation project in South Africa. Participants ranked barriers to PrEP access and use, with early clinic closures listed as the biggest challenge, followed by community PrEP-related stigma, pill burden, side effects, partner resistance, and missed appointments. Their proposed solutions included after-hours clinic opening times and alternative delivery models such as mobile clinics, home courier delivery, locker pick-up, and pharmacy access; community education led by providers and peers; long-acting PrEP (particularly injectables); side-effect remedies and lower-toxicity options like vaginal rings; co-packaging of PrEP and condoms with educational materials; and appointments reminders. Participants also designed their “dream PrEP delivery package.” Participants wanted discreet packaging, convenient delivery platforms, and bundled access to sexual and reproductive health products, including PrEP, condoms, self-test kits, and menstrual hygiene items. Engaging pregnant or parenting young women as co-designers of PrEP delivery strategies is feasible and generates practical, user-driven solutions. Their insights underscore the importance of stigma-free, community-based, convenient, differentiated, and person-centred PrEP delivery.

Exploring Facilitators and Barrier to PrEP Access, Use and Adherence for Indigenous Peoples in the Greater Toronto Area

We developed and implemented a PrEP navigation program ("SNAPS") in a NYC safety-net hospital with the objectives to co-locate navigation, clinical PrEP services, and payment assistance. Adherence and retention to PrEP-related care were assessed by mean medication possession ratios (MPRs) and number of appointments over 12 months. Compared to the pre-SNAPS cohort, the post-SNAPS cohort was less likely to be cisgender male (64.8% vs. 84.2%), White (6.5% vs. 23%) and to speak English (33.3% vs. 80.6%) (all p < 0.001). Mean MPR was lower for post-SNAPS (0.68, SD = 0.33) compared to pre-SNAPS (0.89, SD = 0.22) (p = 0.001). Among post-SNAPS patients, cisgender men and MSM were more likely to be retained in PrEP care compared to cisgender women (p < 0.05). Although SNAPS linked diverse patients to PrEP-care, mean MPR was lower post-SNAPS compared to the pre-SNAPS. Continued investments to strengthen later stages of the PrEP cascade model for all populations vulnerable to HIV are needed.

BACKGROUNDPre-exposure prophylaxis (PrEP) provision routes across Europe differ notably between governmental and non-governmental pathways. The introduction of long-acting (LA)-PrEP may further diversify provision dynamics.AIMWe investigated disparities in PrEP access and whether access pathways determine oral PrEP use patterns and LA-PrEP intention among PrEP-experienced men who have sex with men (MSM).METHODSUsing data from 7,505 PrEP-experienced MSM from a cross-sectional survey (PROTECT; 20 European countries, October 2023–April 2024), we used latent class analysis (LCA) to identify MSM's latent socioeconomic positions (SEPs), and logistic regression to compare the likelihood of accessing governmental/non-governmental pathways, and compare oral PrEP adherence, discontinuation and LA-PrEP intention between governmental/non-governmental pathways.RESULTSMost MSM accessed PrEP via governmental pathways (n = 6,671; 88.9%), 11.1% (n = 834) used non-governmental pathways. The LCA identified three groups: employed MSM with more advantaged SEPs, younger MSM with less advantaged SEPs, and older MSM with more advantaged SEPs. Compared with the first group, younger MSM with less advantaged SEPs were significantly more likely to access PrEP via non-governmental pathways (aOR = 1.27; 95% confidence interval (CI): 1.04–1.55). Accessing PrEP via non-governmental pathways was associated with suboptimal adherence (aOR = 1.28; 95% CI: 1.03–1.58), discontinuation (aOR = 3.55; 95% CI: 2.99–4.21), but also higher LA-PrEP intention (aOR = 1.28; 95% CI: 1.06–1.56).CONCLUSIONSInequalities exist in PrEP access among MSM in Europe. While non-governmental pathways offer opportunities to engage MSM with less advantaged SEPs, oral PrEP use patterns via this pathway were not optimal. Tailored efforts should ensure that PrEP is accessible and affordable to enhance current use and prepare for future LA-PrEP modalities.

Extending PrEP access and coverage in France.

HIV pre‐exposure prophylaxis initiation in community safe spaces increases PrEP access among key populations in Zambia

Adolescent girls and young women (AGYW) face a high HIV burden, while PrEP persistence often declines post-trial. Understanding access outside research settings is key to improving study-to-clinic transitions. This study explored AGYW's experiences accessing PrEP in public clinics after The Community PrEP Study (CPS) in Eastern Cape, South Africa, a 24-month behavioral intervention. AGYW referred to clinics post-study (June-November 2021) were interviewed on their transition experiences. Interviewers categorized participants as PrEP continuation, discontinuation, or non-presentation. The qualitative team iteratively coded transcripts, used matrix analysis and discussions to examine referral experiences, clinic access, and PrEP motivations. While most accepted the transition, many missed study support. Continuation was linked to clinic adaptation, while discontinuation stemmed from access barriers. Non-presentation resulted from logistical and privacy concerns. Recommendations included youth-friendly provider training, alternative PrEP pick-up options, and service integration. Provider engagement and training remain critical for optimizing PrEP access, even with long-acting modalities.Trial registration number NCT03977181. Date of registration: 6 June 2019 - retrospectively registered.

Same-day pre-exposure prophylaxis for HIV (PrEP) is recommended to improve access to this important HIV prevention tool. A PrEP program at a community-based LGBTQ+ clinic in Seattle, Washington provided PrEP via telemedicine with a focus on converting testing-only visits to same-day ‘Insta-PrEP’ visits. We identified three key barriers to same-day PrEP for clients who present to clinic for testing-only visits: delays related to health insurance; longer counseling times; and disruption of clinic flow following Insta-PrEP visits.

BackgroundIn Vietnam, PrEP was introduced in 2017 and scaled up from 2019. Private sector engagement (PSE) in PrEP service delivery was deployed as a strategy from the start to increase PrEP access. We assessed the effectiveness of this approach to inform ongoing efforts to accelerate epidemic control by 2030.MethodsWe implemented a process evaluation with longitudinal design using retrospective programmatic data collected and uploaded onto a secure online system (HMED) from 23 public and 17 private PrEP clinics in Hanoi, Ho Chi Minh City (HCMC), and Dong Nai. We measured the effectiveness of PrEP service delivery by PrEP initiation/reinitiation, uptake, persistence, discontinuation, and HIV seroconversion. We used the Kaplan-Meier time-to-event approach to estimate PrEP persistence and mixed-effects logistic regression analysis to assess factors associated with the PrEP persistence.ResultsFrom October 2017 to September 2023, 29,944 individuals initiated PrEP, and among these, 79.3% started PrEP at a private sector clinic while 20.7% initiated in a public sector clinic. The median duration of PrEP use persistence at private clinics was significantly longer than that at public clinics (268 days vs. 148 days, respectively). Mixed-effects logistic regression analysis results indicated a significant statistical association between PrEP persistence for at least three months and initiating PrEP at a private clinic [adjusted odds ratio [aOR] = 4.28; 95% confidence interval [CI]: 2.96–6.19], opting for TelePrEP (aOR = 3.42; 95% CI: 2.12–5.53), or being 20 years of age or older (aOR = 1.86; 95% CI: 1.62–2.13). HIV seroconversion was significantly lower among PrEP users at private clinics compared to public clinics (0.03 vs. 0.13 per 100 person-years, respectively; p < 0.01).ConclusionOffering choice in PrEP service delivery options is essential to increase access and uptake. Private-sector PrEP providers play a pivotal role in increasing PrEP uptake and coverage in Vietnam, and will be critical to delivery of new long-acting options.

Cisgender Black women in the U.S. face disproportionately high HIV rates due to systemic inequities rooted in institutional racism, not individual behaviors. These disparities are particularly severe in the southern U.S., driven by limited access to healthcare, economic instability, and unsafe social environments. Despite its proven effectiveness, PrEP remains significantly underutilized in this population. This systematic review followed PRISMA guidelines to identify and select relevant studies and used the CASP checklist to appraise the quality of the selected qualitative studies. The review focuses on individual and systemic barriers to PrEP access for cisgender Black women, aiming to guide equitable health interventions and improve HIV prevention efforts. Key barriers include limited PrEP awareness, medical mistrust, and stigma. Financial, structural, and social determinants also hinder access. Facilitators, such as PrEP education, social normalization, trust building, and affordability, were identified as critical to improving uptake. The findings emphasize the need for culturally tailored strategies that build trust, provide education, and empower cisgender Black women to overcome barriers to PrEP access.

To analyze the impact of intersecting systems of oppression on the continuum of PrEP care among adolescent gays, bisexuals, and other men who have sex with men (aGBMSM), and to examine how health professionals (HP) identify and address these challenges to provide sexual health care and HIV prevention. This qualitative exploratory study was part of a cohort research project involving aGBMSM, travesties, and transgender women (aTrTW) using PrEP. Data analyzed consisted of 16 interviews with aGBMSM and eight with health professionals (HPs) in São Paulo study site. The methodological and theoretical framework for the interactive categorization of thematic analysis was based on an intersectional approach. The knowledge of aGBMSM about PrEP was influenced by the adverse effects of systems of oppression, particularly among Black adolescents, who acquired knowledge in a less technical manner compared to White adolescents. Most professionals recognized oppression and its impact on the PrEP care continuum (PrEPCC), especially noting the presence of racism. However, few articulated how different social markers compound barriers to the success of the PrEPCC. Social oppression affects the success of the PrEP care continuum (PrEPCC) in multiple ways. Health professionals (HPs) play a crucial role in mitigating and not perpetuating these negative experiences within health services, as well as in PrEP access, use, and adherence.