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Optimizing Content for Pre-exposure Prophylaxis (PrEP) Counseling for Men Who Have Sex with Men: Perspectives of PrEP Users and High-Risk PrEP Naïve Men

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Abstract

Existing trials of antiretroviral (ARV) medication as chemoprophylaxis against HIV reveal that the degree of protection is primarily dependent on product adherence. However, there is a lack of data on targets for behavioral interventions to improve adherence to ARV as prevention. Information from individuals who have used ARV as pre-exposure prophylaxis (PrEP) can inform behavioral intervention development. Thirty-nine HIV-uninfected MSM at high risk for HIV acquisition participated in one of four semi-structured focus groups. Two of the focus groups consisted of MSM who had been prescribed and used PrEP in the context of a clinical trial; the other two consisted of high-risk MSM who had not previously used PrEP. An in-depth, within-case/across-case content analysis resulted in six descriptive themes potentially salient for a PrEP adherence behavioral intervention: (1) motivations to use PrEP, (2) barriers to PrEP use, (3) facilitators to PrEP use, (4) sexual decision-making in the context of PrEP, (5) prospective PrEP education content, and, (6) perceived effective characteristics of PrEP delivery personnel. Addressing these themes in behavioral interventions in the context of prescribing PrEP may result in the optimal “packaging” public health programs that implement PrEP for high-risk MSM.

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Acknowledgments

This project was supported by Grant number 1R34MH095584-01 R (PI: Mayer, Co-PI Safren) from the National Institute of Mental Health (NIMH). The content is solely the responsibility of the authors and does not necessarily represent the official views of NIMH or the National Institutes of Health. The authors would like to thank Drs. David Bangsberg and Jessica Haberer for their consultation on this project, Dr. Douglas Krakower for being the MD present during all focus group meetings, and members of the Fenway Institute Community Advisory Board who helped us shape the interview guide.

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Authors and Affiliations

  1. The Fenway Institute, Fenway Health, Boston, MA, 02215, USA

    S. Wade Taylor, Kenneth H. Mayer, Steven M. Elsesser, Matthew J. Mimiaga, Conall O’Cleirigh & Steven A. Safren

  2. Division of Infectious Diseases, Department of Medicine, Harvard Medical School/Beth Israel Deaconess Medical Center, Boston, MA, USA

    Kenneth H. Mayer

  3. Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, Boston, MA, USA

    Matthew J. Mimiaga, Conall O’Cleirigh & Steven A. Safren

  4. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    Matthew J. Mimiaga

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  1. S. Wade Taylor
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Correspondence to S. Wade Taylor.

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Wade Taylor, S., Mayer, K.H., Elsesser, S.M. et al. Optimizing Content for Pre-exposure Prophylaxis (PrEP) Counseling for Men Who Have Sex with Men: Perspectives of PrEP Users and High-Risk PrEP Naïve Men. AIDS Behav 18, 871–879 (2014). https://doi.org/10.1007/s10461-013-0617-7

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