Perspectives of a peer-driven approach to improve pre-exposure prophylaxis and HIV prevention among Black/African American and Hispanic/Latino men who have sex with men
Jun Tao A B C # * , Collette Sosnowy A B # , Trisha Arnold D , Jhanavi Kapadia A , Hannah Parent B , Brooke G. Rogers A B , Alexi Almonte B and Philip A. Chan A B EA Division of Infectious Diseases, Brown University Warren Alpert Medical School, 593 Eddy Street, Providence, RI 02903, USA.
B Division of Infectious Diseases, The Miriam Hospital, 11 4th Street, Providence, RI 02906, USA.
C Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI 02912, USA.
D Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, 345 Blackstone Boulevard, Providence, RI 02906, USA.
E Department of Behavioral and Social Sciences, Brown University School of Public Health, 8th floor, 121 South Main Street, Providence, RI 02912, USA.
Handling Editor: Anthony Smith
Abstract
Black/African American (B/AA) and Hispanic/Latino (H/L) men who have sex with men (MSM) are significantly less likely than white MSM to initiate pre-exposure prophylaxis (PrEP). A peer-driven intervention (PDI) may be an effective approach to addressing this disparity. In this study, we explored community member perspectives of a PDI to promote PrEP uptake among B/AA and H/L MSM.
We conducted semi-structured interviews with B/AA and H/L HIV-negative MSM between August 2018 and October 2019 in Rhode Island, USA. Participants reported their perspectives and recommendations for a PDI. Data from participant responses were thematically analysed.
Of 15 MSM, the median age was 25 years (interquartile range: 22, 33). The majority identified as B/AA (53.3%), H/L (66.7%), and having a college education or above (53.3%). Most participants viewed a PDI positively and were willing to learn and promote PrEP among their peers. Participants identified and supported several potential intervention components, such as education about the benefit of PrEP, emphasising prevention-effective dosing, and clarifying no prevention effect towards other sexually transmitted infections. They preferred in-person meetings to electronic communication. Preferred characteristics of peer educators included compassion, good communication skills, and enthusiasm about PrEP.
This in-depth qualitative interview suggested that a PDI approach is promising in promoting PrEP uptake, as it could deliver culturally appropriate education and encourage PrEP uptake via peer influence among B/AA and H/L MSM.
Keywords: Black/African American, hard-to-reach populations, Hispanic/Latino, HIV, LGBT sexual health, men who have sex with men (MSM), peer-driven intervention, pre-exposure prophylaxis (PrEP).
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