Barriers to uptake among GBMSM who did not initiate PrEP
infectious disease, ’ desire
INFECTIOUS DISEASE, MEDICATION SIDE EFFECTS
Overall, 81.4% of participants (n = 51) did not initiate PrEP (i.e. not obtained PrEP medication through this study) during the study. The most common four barriers to PrEP use identified by these participants in the Week 8 follow-up survey were “financial concerns of PrEP” (n = 32, 62.7%), “worries about PrEP medication side effects” (n = 20, 39.2%), “prefer to use other HIV prevention strategies (e.g., condom)” (n = 17, 33.3%), and “do not like taking any medication” (n = 15, 29.4%). In qualitative interviews with nine participants who never initiated PrEP (i.e. not obtained PrEP medication through this study), besides the aforementioned barriers, themes emerged related to logistical/procedural barriers and psychosocial barriers. The logistical barriers included the anticipated burden of ongoing PrEP care and the limited operating hours of the PrEP clinic at the study hospital. As stated by one participant:
Psychosocial barriers focused on stigma, including the perceived stigma surrounding patients at infectious disease specialty hospitals, as well as generalized HIV-related stigma within society. The current way that PrEP was provided was at odds with participants’ desire to maintain privacy around their sexual identity, and avoid association with HIV.
