Structural barriers to pre-exposure prophylaxis use among young sexual minority men: The P18 cohort study

Jessica Jaiswal, Marybec Griffin, Stuart N. Singer, Richard E. Greene, Ingrid Lizette Zambrano Acosta, Saara K. Kaudeyr, Farzana Kapadia, Perry N. Halkitis

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Despite decreasing rates of HIV among many populations, HIV-related health disparities among gay, bisexual and other men who have sex with men persist, with disproportional percentages of new HIV diagnoses among racial and ethnic minority men. Despite increasing awareness of HIV pre-exposure prophylaxis (PrEP), PrEP use remains low. In addition to exploring individual-level factors for this slow uptake, structural drivers of PrEP use must also be identified in order to maximize the effectiveness of biomedical HIV prevention strategies. Method: Using cross-sectional data from an ongoing cohort study of young sexual minority men (N=492), we examine the extent to which structural-level barriers, including access to health care, medication logistics, counseling support, and stigma are related to PrEP use. Results: While almost all participants indicated awareness of PrEP, only 14% had ever used PrEP. PrEP use was associated with lower concerns about health care access, particularly paying for PrEP. Those with greater concerns talking with their provider about their sexual behaviors were less likely to use PrEP. Conclusion: Paying for PrEP and talking to one’s provider about sexual behaviors are concerns for young sexual minority men. In particular, stigma from healthcare providers poses a significant barrier to PrEP use in this population. Providers need not only to increase their own awareness of and advocacy for PrEP as an effective risk-management strategy for HIV prevention, but also must work to create open and non-judgmental spaces in which patients can discuss sexual behaviors without the fear of stigma.

Original languageEnglish (US)
Pages (from-to)237-249
Number of pages13
JournalCurrent HIV Research
Volume16
Issue number3
DOIs
StatePublished - 2018

Keywords

  • Clinicians
  • Diverse
  • Healthcare providers
  • PrEP
  • Pre-exposure prophylaxis
  • Stigma
  • Structural barriers

ASJC Scopus subject areas

  • Infectious Diseases
  • Virology

Fingerprint Dive into the research topics of 'Structural barriers to pre-exposure prophylaxis use among young sexual minority men: The P18 cohort study'. Together they form a unique fingerprint.

Cite this