Thematic synthesis HIV prevention qualitative studies in men who have sex with men (MSM)

Background: Qualitative studies on HIV prevention strategies and methods among men who have sex with men (MSM) allow identify knowledge gaps and improve preventive actions. Objective: To make a thematic synthesis of the scientific productions that use the qualitative methodology in the strategies and methods of HIV prevention area among MSM. Methods: We conducted a literature review following the guidelines of the ENTREQ protocol. The analysis included 48 empirical studies published in Portuguese, English and Spanish between 2001 and 2018 available in the Medline, Embase, Scielo, Scopus, Bireme and Web of Science databases. Results: Where an increased production in the last six years and concentration in northern countries. Seven prevention methods were part of the study, with emphasis on pre-exposure prophylaxis, testing, condoms and behavioral strategies. The main topics discussed were stigma and support and care networks. Conclusion: we notice that an increasing production on prevention in the men who have sex with men segment results from the emergence of multiple preventive methods and strategies and their combined actions beyond the star role of condoms.

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Birth Cohort Variations Across Functional Knowledge of HIV Prevention Strategies, Perceived Risk, and HIV-Associated Behaviors Among Gay, Bisexual, and Other Men Who Have Sex With Men in the United States

American Journal of Men s Health ◽

10.1177/1557988318790875 ◽

2018 ◽

Vol 12 (6) ◽

pp. 1824-1834 ◽

Cited By ~ 4

Author(s):

Akshay Sharma ◽

Erin M. Kahle ◽

Stephen P. Sullivan ◽

Rob Stephenson

Keyword(s):

Hiv Prevention ◽

Birth Cohort ◽

Perceived Risk ◽

The United States ◽

Prevention Strategies ◽

The Past ◽

Hiv Prevention Strategies ◽

Functional Knowledge ◽

Sex With Men ◽

Exposure Prophylaxis

Gay, bisexual, and other men who have sex with men (GBMSM) in the United States remain heavily impacted by HIV. The purpose of this study was to describe intergenerational differences in functional knowledge of HIV prevention strategies, perceived risk, recent condomless anal sex (CAS), and HIV testing behavior. Eight hundred sexually active GBMSM were recruited via Facebook from August to September 2015, and administered a Web-based survey which included 12 multiple-choice questions to elicit data regarding functional knowledge of different HIV prevention approaches (e.g., condom use, pre-exposure prophylaxis post-exposure prophylaxis, treatment as prevention, circumcision). Cumulative logit and multivariable logistic models were formulated to examine birth cohort variations across four analytic outcomes. Younger generations were significantly more knowledgeable, as were GBMSM with higher education. Non-Hispanic non-White GBMSM and those reporting a bisexual/other sexual orientation had lower functional knowledge. Younger generations were equally concerned about contracting HIV as their older counterparts. Perceived risk was significantly higher among non-Hispanic non-White and Hispanic GBMSM, but lower among those with higher education and those in a relationship. Finally, birth cohort variations with respect to engaging in CAS with ≥2 men in the past 3 months and testing for HIV in the past year were not markedly pronounced. Younger GBMSM might be more knowledgeable about HIV prevention strategies compared to their predecessors, but are equally concerned about contracting HIV. Researchers and practitioners should consider intergenerational and other demographic differences while designing multifaceted HIV prevention programs for GBMSM.

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Quality of HIV Websites With Information About Pre-Exposure Prophylaxis or Treatment as Prevention for Men Who Have Sex With Men: Systematic Evaluation (Preprint)

10.2196/preprints.11384 ◽

2018 ◽

Cited By ~ 1

Author(s):

Taylor Silverman ◽

Nicole Asante ◽

Jacob J van den Berg

Keyword(s):

Hiv Prevention ◽

Hiv Infection ◽

Rating Scale ◽

The United States ◽

Treatment As Prevention ◽

Key Words And Phrases ◽

Prevention Strategies ◽

Hiv Prevention Strategies ◽

Sex With Men ◽

Exposure Prophylaxis

BACKGROUND Knowledge and uptake of high-efficacy HIV prevention strategies such as pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP) remain low among men who have sex with men (MSM) who are at the highest risk for HIV infection in the United States. Electronic health (eHealth) interventions are promising tools for disseminating information about these critical yet underutilized strategies and addressing key barriers to uptake among target populations. However, existing HIV prevention websites are understudied and unevaluated. OBJECTIVE This study aimed to systematically review and evaluate existing HIV websites that include information about PrEP or TasP for MSM. METHODS From March 2018 to May 2018, 2 trained research assistants (RAs) entered relevant key words and phrases into 3 commonly used search engines and applied exclusion criteria to all returned results to identify 31 websites included in this review. RAs independently scored each website for authority, usability, interactivity, and PrEP/TasP-related content based on a standardized rating scale and then averaged the results. RESULTS No website received a perfect score in any of the 4 categories, and the average website score was 62% (37/60). Less than a quarter of the websites (23%, 7/31) received a score of more than 75% (7.5/10) for content. Approximately two-thirds of the websites (65%, 20/31) received a score of 50% (5/10) or lower for interactivity. The average score in usability was 68% (6.8/10) and in authority was 69% (6.9/10). Other deficiencies observed included difficulty locating relevant content and lack of information targeting audiences with the highest likelihood of HIV infection. CONCLUSIONS Existing HIV prevention websites with information about PrEP or TasP for MSM fail to provide adequate content as well as present that content to users in an interactive and audience-conscious way. Future eHealth interventions should attempt to rectify these deficiencies to successfully engage and educate MSM at high risk for HIV regarding prevention strategies.

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Awareness, Utilization, and Preferences for Traditional and Contemporary HIV Prevention Strategies Among Facebook and Instagram-Using MSM in the United States

Journal of the International Association of Providers of AIDS Care (JIAPAC) ◽

10.1177/23259582211024770 ◽

2021 ◽

Vol 20 ◽

pp. 232595822110247

Author(s):

Akshay Sharma ◽

Ariana Paredes-Vincent ◽

Erin M. Kahle

Keyword(s):

Hiv Prevention ◽

The United States ◽

Easy Access ◽

Individual Risk ◽

Post Exposure Prophylaxis ◽

Prevention Strategies ◽

Hiv Prevention Strategies ◽

And Bisexual ◽

Sex With Men ◽

Exposure Prophylaxis

HIV prevention research among men who have sex with men (MSM) has traditionally focused on individual risk reduction strategies. Our study evaluated awareness, utilization, and preferences for 10 complementary HIV prevention strategies among 1,286 MSM recruited via Facebook and Instagram from June-August 2018. Ages ranged from 18-85 years, and the majority were non-Hispanic white (n = 1,019, 79.24%), college-educated (n = 819, 63.69%), gay-identifying (n = 1,074, 83.51%), and partnered (n = 808, 62.83%). Post-exposure prophylaxis was the least familiar option, and engaging in sexual activities other than anal sex was the most utilized option. Progressively older and bisexual-identifying MSM were less likely, but those with higher educational levels and easy access to local HIV resources were more likely to be aware of and to be utilizing a greater number of strategies. Additionally, Hispanic MSM were less likely to be aware of, and those in a “closed” relationship were less likely to be utilizing a greater number of strategies. In a subset of 775 multiple strategy users, pre-exposure prophylaxis, regularly testing for HIV, and limiting the number of sex partners emerged as the most preferred options. Combination intervention packages for MSM should be tailored to personal circumstances, including sexual orientation, relationship characteristics and access to local HIV resources.

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Sexual Identity Disclosure and Awareness of HIV Prevention Methods Among Black Men Who Have Sex With Men

The Journal of Sex Research ◽

10.1080/00224499.2017.1375452 ◽

2017 ◽

Vol 55 (8) ◽

pp. 975-983 ◽

Cited By ~ 8

Author(s):

Ryan J. Watson ◽

Jessica N. Fish ◽

Aerielle Allen ◽

Lisa Eaton

Keyword(s):

Hiv Prevention ◽

Sexual Identity ◽

Black Men ◽

Identity Disclosure ◽

Sex With Men ◽

Sexual Identity Disclosure ◽

Prevention Methods

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Structural Barriers to Pre-exposure Prophylaxis Use Among Young Sexual Minority Men: The P18 Cohort Study

Current HIV Research ◽

10.2174/1570162x16666180730144455 ◽

2018 ◽

Vol 16 (3) ◽

pp. 237-249 ◽

Cited By ~ 16

Author(s):

Jessica Jaiswal ◽

Marybec Griffin ◽

Stuart N. Singer ◽

Richard E. Greene ◽

Ingrid Lizette Zambrano Acosta ◽

...

Keyword(s):

Health Care ◽

Cohort Study ◽

Hiv Prevention ◽

Sexual Behaviors ◽

Sexual Minority ◽

Structural Level ◽

Sexual Minority Men ◽

Hiv Prevention Strategies ◽

Minority Men ◽

Exposure Prophylaxis

Background: Despite decreasing rates of HIV among many populations, HIV-related health disparities among gay, bisexual and other men who have sex with men persist, with disproportional percentages of new HIV diagnoses among racial and ethnic minority men. Despite increasing awareness of HIV pre-exposure prophylaxis (PrEP), PrEP use remains low. In addition to exploring individual-level factors for this slow uptake, structural drivers of PrEP use must also be identified in order to maximize the effectiveness of biomedical HIV prevention strategies. Method: Using cross-sectional data from an ongoing cohort study of young sexual minority men (N=492), we examine the extent to which structural-level barriers, including access to health care, medication logistics, counseling support, and stigma are related to PrEP use. Results: While almost all participants indicated awareness of PrEP, only 14% had ever used PrEP. PrEP use was associated with lower concerns about health care access, particularly paying for PrEP. Those with greater concerns talking with their provider about their sexual behaviors were less likely to use PrEP. Conclusion: Paying for PrEP and talking to one’s provider about sexual behaviors are concerns for young sexual minority men. In particular, stigma from healthcare providers poses a significant barrier to PrEP use in this population. Providers need not only to increase their own awareness of and advocacy for PrEP as an effective risk-management strategy for HIV prevention, but also must work to create open and non-judgmental spaces in which patients can discuss sexual behaviors without the fear of stigma.

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Southern African guidelines for the safe use of pre-exposure prophylaxis in men who have sex with men who are at risk for HIV infection

Southern African Journal of HIV Medicine ◽

10.4102/sajhivmed.v13i2.136 ◽

2012 ◽

Vol 13 (2) ◽

Cited By ~ 2

Author(s):

Southern African HIV Clinicians Society Consensus Committee

Keyword(s):

At Risk ◽

Renal Function ◽

Hiv Prevention ◽

Hepatitis B ◽

Hiv Infection ◽

Creatinine Clearance ◽

Fixed Dose ◽

Sex With Men ◽

Exposure Prophylaxis ◽

Hiv Negative

Background. The use of oral antiretrovirals to prevent HIV infection among HIV-negative men who have sex with men (MSM) has been shown to be safe and efficacious. A large, randomised, placebo-controlled trial showed a 44% reduction in the incidence of HIV infection among MSM receiving a daily oral fixed-dose combination of tenofovir disoproxil fumarate and emtricitabine (Truvada) in combination with an HIV prevention package. Improved protection was seen with higher levels of adherence. Aim. The purpose of this guideline is to: (i) explain what pre-exposure prophylaxis (PrEP) is; (ii) outline current indications for its use; (iii) outline steps for appropriate client selection; and (iv) provide guidance for monitoring and maintaining clients on PrEP. Method. PrEP is indicated for HIV-negative MSM who are assessed to be at high risk for HIV acquisition and who are willing and motivated to use PrEP as part of a package of HIV prevention services (including condoms, lubrication, sexually transmitted infection (STI) management and risk reduction counselling). Recommendations. HIV testing, estimation of creatinine clearance and STI and hepatitis B screening are recommended as baseline investigations. Daily oral Truvada, along with adherence support, can then be prescribed for eligible MSM. PrEP should not be given to MSM with abnormal renal function, nor to clients who are unmotivated to use PrEP as part of an HIV prevention package; nor should it be commenced during an acute viral illness. Three-monthly follow-up visits to assess tolerance, renal function, adherence and ongoing eligibility is recommended. Six-monthly STI screens and annual creatinine levels to estimate creatinine clearance are recommended. Hepatitis B vaccination should be provided to susceptible clients. Gastro-intestinal symptoms and weight loss are common side-effects, mostly experienced for the first 4 - 8 weeks after initiating PrEP. There is a risk of the development of antiretroviral resistance among those with undiagnosed acute HIV infection during PrEP initiation and among those with sub-optimal adherence who become HIV infected while on PrEP. Risk compensation (increasing sexual behaviours that can result in exposure to HIV) while on PrEP may become a concern, and clinicians should continue to support MSM clients to continue to use condoms, condom-compatible lubrication and practice safer sex. Research is ongoing to assess optimum dosing regimens, potential long-term effects and alternative PrEP medications. Recommendations for the use of PrEP among other at-risk individuals, and the components of these recommendations, will be informed by future evidence. S Afr J HIV Med 2012;13(2):40-55.

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PrEP in Prisons: HIV prevention in incarcerated populations

International Journal of Prisoner Health ◽

10.1108/ijph-09-2019-0053 ◽

2019 ◽

Vol 16 (2) ◽

pp. 199-206

Author(s):

Jordan Parsons ◽

Chelsea Cox

Keyword(s):

Hiv Prevention ◽

Harm Reduction ◽

New Approach ◽

Content Type ◽

Harm Reduction Intervention ◽

Access To Health ◽

Prevention Interventions ◽

High Risk Populations ◽

Sex With Men ◽

Exposure Prophylaxis

Purpose The purpose of this paper is to discuss the possibility of using pre-exposure prophylaxis (PrEP) as an HIV harm reduction intervention in prisons. PrEP is primarily discussed in relation to men who have sex with men (MSM), meaning other high-risk populations, such as prisoners, are often side-lined. The authors wanted to consider how it could prove beneficial beyond the MSM community. Design/methodology/approach First, the authors discuss whether the common objections to existing HIV harm reduction interventions in prisons, such as needle exchanges, are applicable to PrEP. The authors then apply common objections to the provision of PrEP in the general population to the provision of PrEP in a prison context in order to assess their strength. Finally, the authors discuss what the authors anticipate to be a key objection to PrEP in prisons: post-incarceration access. Findings The authors argue that both sets of common objections considered are easily refuted in the case of PrEP in prisons. The unique setting and nature of the intervention are such that it is without immediately apparent flaws. In addressing post-incarceration access, the authors suggest that a longitudinal consideration of a prisoner’s HIV risk undermines the objection. Originality/value This discussion is of importance due to the significantly heightened risk of HIV infection prisoners are subject to. Not only do effective HIV prevention interventions in prisons contribute to fair access to health for incarcerated individuals, but also to the wider fight against HIV. The authors demonstrate that PrEP has potential as a new approach and call for further research in this area.

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Understanding the Social Influences on Engaging Key Populations With HIV Prevention: A Qualitative Study With Men Who Have Sex With Men in Three Indonesian Cities

AIDS Education and Prevention ◽

10.1521/aeap.2019.31.3.206 ◽

2019 ◽

Vol 31 (3) ◽

pp. 206-223 ◽

Cited By ~ 4

Author(s):

Elan Lazuardi ◽

Christy E. Newman ◽

Irma Anintya Tasya ◽

Emily Rowe ◽

D. N. Wirawan ◽

...

Keyword(s):

Hiv Prevention ◽

Service Access ◽

Key Populations ◽

Social Dimensions ◽

Structured Interviews ◽

Outreach Workers ◽

Hiv Prevention Strategies ◽

The Social ◽

Sex With Men ◽

The Many

The globally recognized test and treat approach underpins Indonesian national strategies to reduce and prevent HIV among key populations, including men who have sex with men. More comprehensive understanding of how engagement with HIV prevention is shaped by social and community practices will support these efforts. Between 2015 and 2016, focus groups and semi-structured interviews were conducted with 54 men who have sex with men in three urban settings in Indonesia to elicit their views on, and experiences of, HIV prevention and care. Focused on data relating to testing, findings documented the important influence of informal peer networks, community-based organizations and outreach workers. Some social dimensions of service access complicated this, particularly fear of stigma or lack of confidentiality in large service settings. The many differences between men challenges assumptions that a single set of HIV prevention strategies will work to engage all men who have sex with men living in Indonesia.

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