Abstract
Background HIV-related incidence and mortality is increasing across Peru, with highest mortality rates recorded in Amazonian Loreto. This epidemic is concentrated in men who have sex with men, a population with 14% HIV treatment adherence despite free national provision. This study investigates barriers and facilitators to following healthcare advice through experiences and perceptions of HIV-positive men who have sex with men and healthcare professionals in Loreto. Methods Twenty qualitative interviews with HIV-positive men who have sex with men and one focus group with HIV-specialist healthcare professionals were conducted in Loreto, January-February 2019. Thematic content analysis was used. Results A culture of isolation and discrimination was identified, propagated by poor public knowledge surrounding HIV transmission and treatment. Employment potential was hampered and 7/20 patients had suicidal thoughts post-diagnosis. Barriers to care included: shame, depression, travel cost/times, a preference for traditional plant-based medicine and side-effects of ART. Facilitators included: education, family and clinic support, disease acceptance and lifestyle changes. Conclusion More effective, focussed community education and workplace discrimination investigations are recommended.
HIV Treatment Optimism and Unsafe Anal Intercourse Among HIV-Positive Men Who Have Sex With Men: Findings from the Positive Connections Study