Perceptions of Pre-exposure Prophylaxis (PrEP) and Acceptability of Peer Navigation Among HIV-negative Latinx and Black Men who Have Sex with Men (MSM) in Western Washington
Author | : Jahn Jaramillo |
Publisher | : |
Total Pages | : 47 |
Release | : 2018 |
Genre | : |
ISBN | : |
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HIV PrEP (pre-exposure prophylaxis) is an effective biomedical approach for HIV prevention. However, PrEP is an underutilized resource among Latinx and Black men who have sex with men (MSM) in the United States. Peer navigation approaches are being widely scaled up to support PrEP uptake and adherence, though it remains unclear what strategies work best to effectively address the diverse social and cultural needs of Latinx and Black MSM. This study is based on qualitative research conducted on a subset of 66 Latinx and Black MSM residing in Western Washington who participated in an online CAPI REDCap survey. We conducted semi-structured in-depth interviews with 21 men selected through purposive sampling methods to evaluate the intersectionality of race, ethnicity, sexual orientation, and other identities men possessed and how this related to their views on PrEP in general, and on peer navigation specifically. Thematic analysis was used to identify and analyze emergent themes. Four major themes emerged as relevant to PrEP interest and uptake: 1) disclosure concerns for bisexual/gay masculine identified men; 2) specific challenges for Latinx MSM, including migration status and need for advocacy; 3) specific challenges for Black MSM, including discrimination and need lack of trust; and 4) special considerations for younger men, including limited knowledge and experience discussing sexual health and an interest in more comprehensive peer intervention content. Interest in peer navigation was high among study participants, particularly for men with limited social support or English proficiency and for men who had moved from out of state or another country. Several potential approaches to improve peer navigation were identified, including developing culturally congruent programming to match peers with men based on various identity considerations and identified needs, employing social media such as chatrooms and informational phone lines as complementary combination strategies, and incorporating trauma-informed care into a peer navigation program for Latinx and Black MSM. Tailored peer navigation approaches may help MSM of color by increasing resilience to societal stigma at the individual level, enhancing social support at the interpersonal level and serving as a bridge to providers at the structural level. These strategies could ultimately reduce racial/ethnic HIV disparities, if implemented.