Exploring Stigma, Resilience, and Alternative HIV Preventive Service Delivery Among Young Men who Have Sex with Men of Color.
Allysha C Maragh-Bass, Tia Williams, Harsh Agarwal and 4 others
PMID 37401801WHAT IT FOUND
Men already in PrEP care found home-based telePrEP convenient and less stigmatizing, but still needed in-person labs.
None had heard of injectable PrEP, though all were interested and worried about cost and missed doses.
Key findings
01Participants described stigma in care settings, including stopping primary care because of sexual stigma, while providers with LGBTQIA+ knowledge or training were seen as important for non-stigmatizing PrEP care.
02All participants said home-based PrEP care fulfilled their needs, and they described telePrEP as easy, convenient, and destigmatizing relative to in-person care, though most said in-person care was still needed for blood work or serious concerns.
03No participants had heard of long-acting injectable PrEP, but all expressed interest; most preferred injections at a community or clinic venue rather than at home, and raised concerns about cost, side effects, effectiveness, injection sites, and missed doses.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only seven participants were interviewed, and they were a convenience sample recruited during COVID-19, so the themes may not apply to other men, regions, or settings. The study could not compare the parent trial's intervention and control groups because both had been moved to home-based telePrEP care during the pandemic. Participants did not review the findings, and sensitive topics such as stigma and sexual behavior may have been affected by social desirability. The sample was too small to examine differences by race, ethnicity, or region. Although some themes reached saturation, issues around long-acting injectable PrEP were not fully explored.
Declared interests
The paper lists NIH extramural research support. No company funding, sponsor design, or author conflict-of-interest declaration is included in the supplied text.
The easy way to misread this
Do not treat these findings as evidence that home-based PrEP care, telePrEP, or injectable PrEP improves HIV prevention outcomes. The study interviewed seven men already in a PrEP trial, reported their preferences and experiences, and did not test adherence, PrEP persistence, or HIV acquisition.