"That's kind of like the big struggle right now is can we get PrEP?": Facilitators and Barriers to PrEP Uptake Among Active Duty Gay and Bisexual Men.

Autor: Beltran RM; Division of Infectious Diseases, UCLA David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA USA., Schuyler AC; School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR USA., Blair CS; Division of Infectious Diseases, UCLA David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA USA., Goldbach JT; Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA USA., Castro CA; Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA USA., Holloway IW; Department of Social Welfare, School of Public Affairs, UCLA Luskin, University of California, Los Angeles, Los Angeles, CA USA.
Jazyk: angličtina
Zdroj: Sexuality research & social policy : journal of NSRC : SR & SP [Sex Res Social Policy] 2023; Vol. 20 (2), pp. 413-425. Date of Electronic Publication: 2021 Aug 20.
DOI: 10.1007/s13178-021-00622-6
Abstrakt: Introduction: The US Military is experiencing a rise in HIV infections among gay and bisexual men (GBM) serving on active duty, yet little is known about this population's uptake of pre-exposure prophylaxis (PrEP), an evidence-based intervention for HIV prevention. This mixed methods study examines the facilitators and barriers to PrEP access and uptake among active duty GBM.
Methods: Active duty GBM were recruited using respondent-driven sampling (2017 and 2018). Participants ( n  = 93) answered quantitative survey questions on PrEP interest and accessibility. Another set of participants ( n  = 10) discussed their PrEP experiences in qualitative interviews . We conducted descriptive and bivariate analyses of quantitative data, while qualitative data were analyzed using structural and descriptive coding techniques.
Results: Approximately 71% of active duty GBM indicated interest in accessing PrEP. A greater proportion of those who disclosed (vs. did not disclose) their sexual orientation to their military doctor discussed ( p  < 0.001) or accessed ( p  = 0.017) PrEP. The following qualitative themes emerged: (1) providers' negative views and knowledge gaps related to PrEP; (2) lack of a systems approach to PrEP access; (3) confidentiality concerns; and (4) reliance on peer networks for PrEP guidance and support.
Conclusions: Study results indicate that active duty GBM are interested in and want to discuss PrEP with their military doctors, but gaps in providers' PrEP-related knowledge and skills, as well as mistrust in the military health care system, remain.
Policy Implications: A system-wide approach that addresses confidentiality concerns and removes procedural barriers to PrEP access is recommended to improve PrEP uptake in this population.
Competing Interests: Competing InterestsThe authors declare no competing interests.
(© The Author(s) 2021.)
Databáze: MEDLINE
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