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For: Quinn K, Dickson-Gomez J, Zarwell M, Pearson B, Lewis M. "A Gay Man and a Doctor are Just like, a Recipe for Destruction": How Racism and Homonegativity in Healthcare Settings Influence PrEP Uptake Among Young Black MSM. AIDS Behav 2019;23:1951-63. [PMID: 30565092 DOI: 10.1007/s10461-018-2375-z] [Citation(s) in RCA: 162] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]

For:	Quinn K, Dickson-Gomez J, Zarwell M, Pearson B, Lewis M. "A Gay Man and a Doctor are Just like, a Recipe for Destruction": How Racism and Homonegativity in Healthcare Settings Influence PrEP Uptake Among Young Black MSM. AIDS Behav 2019;23:1951-63. [PMID: 30565092 DOI: 10.1007/s10461-018-2375-z] [Citation(s) in RCA: 162] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]

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Cited by Other Article(s)

Tanner MR, O’Shea JG, Byrd KM, Johnston M, Dumitru GG, Le JN, Lale A, Byrd KK, Cholli P, Kamitani E, Zhu W, Hoover KW, Kourtis AP. Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV - CDC Recommendations, United States, 2025. MMWR Recomm Rep 2025;74:1-56. [PMID: 40331832 PMCID: PMC12064164 DOI: 10.15585/mmwr.rr7401a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2025] Open

Abstract

Nonoccupational postexposure prophylaxis (nPEP) for HIV is recommended when a nonoccupational (e.g., sexual, needle, or other) exposure to nonintact skin or mucous membranes that presents a substantial risk for HIV transmission has occurred, and the source has HIV without sustained viral suppression or their viral suppression information is not known. A rapid HIV test (also referred to as point-of-care) or laboratory-based antigen/antibody combination HIV test is recommended before nPEP initiation. Health care professionals should ensure the first dose of nPEP is provided as soon as possible, and ideally within 24 hours, but no later than 72 hours after exposure. The initial nPEP dose should not be delayed due to pending results of any laboratory-based testing, and the recommended length of nPEP course is 28 days. The recommendations in these guidelines update the 2016 nPEP guidelines (CDC. Updated guidelines for antiretroviral postexposure prophylaxis after sexual, injection drug use, or other nonoccupational exposure to HIV - United States, 2016. Atlanta, GA: US Department of Health and Human Services, CDC; 2017). These 2025 nPEP guidelines update recommendations and considerations for use of HIV nPEP in the United States to include newer antiretroviral (ARV) agents, updated nPEP indication considerations, and emerging nPEP implementation strategies. The guidelines also include considerations for testing and nPEP regimens for persons exposed who have received long-acting injectable ARVs in the past. Lastly, testing recommendations for persons who experienced sexual assault were updated to align with the most recent CDC sexually transmitted infection treatment guidelines. These guidelines are divided into two sections: Recommendations and CDC Guidance. The preferred regimens for most adults and adolescents are now bictegravir/emtricitabine/tenofovir alafenamide or dolutegravir plus (tenofovir alafenamide or tenofovir disoproxil fumarate) plus (emtricitabine or lamivudine). However, the regimen can be tailored to the clinical circumstances. Medical follow-up for persons prescribed nPEP also should be tailored to the clinical situation; recommended follow-up includes a visit at 24 hours (remote or in person) with a medical provider, and clinical follow-up 4-6 weeks and 12 weeks after exposure for laboratory testing. Persons initiating nPEP should be informed that pre-exposure prophylaxis for HIV (PrEP) can reduce their risk for acquiring HIV if they will have repeat or continuing exposure to HIV after the end of the nPEP course. Health care professionals should offer PrEP options to persons with ongoing indications for PrEP and create an nPEP-to-PrEP transition plan for persons who accept PrEP.

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Kay ES, Shourya S, Brin M, Batey DS, Radix A, Belkind U, Tanner M, Galindo C, Ferrara S, Ott C, Schnall R. Pre-exposure Prophylaxis Providers in Birmingham, Alabama, and New York City, New York, Identify Critical Barriers to Newer Pre-exposure Prophylaxis Strategies: A Mixed Methods Study. J Assoc Nurses AIDS Care 2025;36:284-296. [PMID: 40272038 PMCID: PMC12037144 DOI: 10.1097/jnc.0000000000000532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2025]

Affiliation(s)

Emma Sophia Kay Emma Sophia Kay, PhD, MSW, is an Associate Professor, University of Alabama at Birmingham, School of Nursing, Birmingham, Alabama, USA Shivesh Shourya, BS, is a graduate student, Yale University School of Public Health, New Haven, Connecticut, USA Maeve Brin, BA, is an Assistant Manager, Columbia University School of Nursing, New York City, New York, USA D. Scott Batey, PhD, MSW, is a Professor at Tulane University School of Social Work, New Orleans, Louisiana, USA Asa Radix, MD, PhD, MPH, FACP, is the Executive Vice President, Callen-Lorde, New York City, New York, USA Uri Belkind, MD, MS, FAAP, AAHIVS, is the Associate Director of Medicine for Adolescent Medicine, Callen-Lorde, New York City, New York, USA Mary Tanner, MD, FAAP, was the Lead Project Officer, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Carla Galindo, MPH, CHES, is Co-Project Officer, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Stephen Ferrara, DNP, FNP, FAANP, FAAN, is a Professor of Nursing, Columbia University School of Nursing, New York City, New York, USA Corilyn Ott, PhD, is a Research Assistant, University of Alabama at Birmingham, School of Nursing and School of Medicine, Birmingham, Alabama, USA Rebecca Schnall, PhD, MPH, RN-BC, FAAN, is a Mary Dickey Lindsay Professor of Disease Prevention and Health Promotion and Associate Dean of Faculty Development, Columbia University School of Nursing, New York City, New York, USA
Shivesh Shourya Emma Sophia Kay, PhD, MSW, is an Associate Professor, University of Alabama at Birmingham, School of Nursing, Birmingham, Alabama, USA Shivesh Shourya, BS, is a graduate student, Yale University School of Public Health, New Haven, Connecticut, USA Maeve Brin, BA, is an Assistant Manager, Columbia University School of Nursing, New York City, New York, USA D. Scott Batey, PhD, MSW, is a Professor at Tulane University School of Social Work, New Orleans, Louisiana, USA Asa Radix, MD, PhD, MPH, FACP, is the Executive Vice President, Callen-Lorde, New York City, New York, USA Uri Belkind, MD, MS, FAAP, AAHIVS, is the Associate Director of Medicine for Adolescent Medicine, Callen-Lorde, New York City, New York, USA Mary Tanner, MD, FAAP, was the Lead Project Officer, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Carla Galindo, MPH, CHES, is Co-Project Officer, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Stephen Ferrara, DNP, FNP, FAANP, FAAN, is a Professor of Nursing, Columbia University School of Nursing, New York City, New York, USA Corilyn Ott, PhD, is a Research Assistant, University of Alabama at Birmingham, School of Nursing and School of Medicine, Birmingham, Alabama, USA Rebecca Schnall, PhD, MPH, RN-BC, FAAN, is a Mary Dickey Lindsay Professor of Disease Prevention and Health Promotion and Associate Dean of Faculty Development, Columbia University School of Nursing, New York City, New York, USA
Maeve Brin Emma Sophia Kay, PhD, MSW, is an Associate Professor, University of Alabama at Birmingham, School of Nursing, Birmingham, Alabama, USA Shivesh Shourya, BS, is a graduate student, Yale University School of Public Health, New Haven, Connecticut, USA Maeve Brin, BA, is an Assistant Manager, Columbia University School of Nursing, New York City, New York, USA D. Scott Batey, PhD, MSW, is a Professor at Tulane University School of Social Work, New Orleans, Louisiana, USA Asa Radix, MD, PhD, MPH, FACP, is the Executive Vice President, Callen-Lorde, New York City, New York, USA Uri Belkind, MD, MS, FAAP, AAHIVS, is the Associate Director of Medicine for Adolescent Medicine, Callen-Lorde, New York City, New York, USA Mary Tanner, MD, FAAP, was the Lead Project Officer, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Carla Galindo, MPH, CHES, is Co-Project Officer, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Stephen Ferrara, DNP, FNP, FAANP, FAAN, is a Professor of Nursing, Columbia University School of Nursing, New York City, New York, USA Corilyn Ott, PhD, is a Research Assistant, University of Alabama at Birmingham, School of Nursing and School of Medicine, Birmingham, Alabama, USA Rebecca Schnall, PhD, MPH, RN-BC, FAAN, is a Mary Dickey Lindsay Professor of Disease Prevention and Health Promotion and Associate Dean of Faculty Development, Columbia University School of Nursing, New York City, New York, USA
D Scott Batey Emma Sophia Kay, PhD, MSW, is an Associate Professor, University of Alabama at Birmingham, School of Nursing, Birmingham, Alabama, USA Shivesh Shourya, BS, is a graduate student, Yale University School of Public Health, New Haven, Connecticut, USA Maeve Brin, BA, is an Assistant Manager, Columbia University School of Nursing, New York City, New York, USA D. Scott Batey, PhD, MSW, is a Professor at Tulane University School of Social Work, New Orleans, Louisiana, USA Asa Radix, MD, PhD, MPH, FACP, is the Executive Vice President, Callen-Lorde, New York City, New York, USA Uri Belkind, MD, MS, FAAP, AAHIVS, is the Associate Director of Medicine for Adolescent Medicine, Callen-Lorde, New York City, New York, USA Mary Tanner, MD, FAAP, was the Lead Project Officer, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Carla Galindo, MPH, CHES, is Co-Project Officer, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Stephen Ferrara, DNP, FNP, FAANP, FAAN, is a Professor of Nursing, Columbia University School of Nursing, New York City, New York, USA Corilyn Ott, PhD, is a Research Assistant, University of Alabama at Birmingham, School of Nursing and School of Medicine, Birmingham, Alabama, USA Rebecca Schnall, PhD, MPH, RN-BC, FAAN, is a Mary Dickey Lindsay Professor of Disease Prevention and Health Promotion and Associate Dean of Faculty Development, Columbia University School of Nursing, New York City, New York, USA
Asa Radix Emma Sophia Kay, PhD, MSW, is an Associate Professor, University of Alabama at Birmingham, School of Nursing, Birmingham, Alabama, USA Shivesh Shourya, BS, is a graduate student, Yale University School of Public Health, New Haven, Connecticut, USA Maeve Brin, BA, is an Assistant Manager, Columbia University School of Nursing, New York City, New York, USA D. Scott Batey, PhD, MSW, is a Professor at Tulane University School of Social Work, New Orleans, Louisiana, USA Asa Radix, MD, PhD, MPH, FACP, is the Executive Vice President, Callen-Lorde, New York City, New York, USA Uri Belkind, MD, MS, FAAP, AAHIVS, is the Associate Director of Medicine for Adolescent Medicine, Callen-Lorde, New York City, New York, USA Mary Tanner, MD, FAAP, was the Lead Project Officer, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Carla Galindo, MPH, CHES, is Co-Project Officer, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Stephen Ferrara, DNP, FNP, FAANP, FAAN, is a Professor of Nursing, Columbia University School of Nursing, New York City, New York, USA Corilyn Ott, PhD, is a Research Assistant, University of Alabama at Birmingham, School of Nursing and School of Medicine, Birmingham, Alabama, USA Rebecca Schnall, PhD, MPH, RN-BC, FAAN, is a Mary Dickey Lindsay Professor of Disease Prevention and Health Promotion and Associate Dean of Faculty Development, Columbia University School of Nursing, New York City, New York, USA
Uri Belkind Emma Sophia Kay, PhD, MSW, is an Associate Professor, University of Alabama at Birmingham, School of Nursing, Birmingham, Alabama, USA Shivesh Shourya, BS, is a graduate student, Yale University School of Public Health, New Haven, Connecticut, USA Maeve Brin, BA, is an Assistant Manager, Columbia University School of Nursing, New York City, New York, USA D. Scott Batey, PhD, MSW, is a Professor at Tulane University School of Social Work, New Orleans, Louisiana, USA Asa Radix, MD, PhD, MPH, FACP, is the Executive Vice President, Callen-Lorde, New York City, New York, USA Uri Belkind, MD, MS, FAAP, AAHIVS, is the Associate Director of Medicine for Adolescent Medicine, Callen-Lorde, New York City, New York, USA Mary Tanner, MD, FAAP, was the Lead Project Officer, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Carla Galindo, MPH, CHES, is Co-Project Officer, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Stephen Ferrara, DNP, FNP, FAANP, FAAN, is a Professor of Nursing, Columbia University School of Nursing, New York City, New York, USA Corilyn Ott, PhD, is a Research Assistant, University of Alabama at Birmingham, School of Nursing and School of Medicine, Birmingham, Alabama, USA Rebecca Schnall, PhD, MPH, RN-BC, FAAN, is a Mary Dickey Lindsay Professor of Disease Prevention and Health Promotion and Associate Dean of Faculty Development, Columbia University School of Nursing, New York City, New York, USA
Mary Tanner Emma Sophia Kay, PhD, MSW, is an Associate Professor, University of Alabama at Birmingham, School of Nursing, Birmingham, Alabama, USA Shivesh Shourya, BS, is a graduate student, Yale University School of Public Health, New Haven, Connecticut, USA Maeve Brin, BA, is an Assistant Manager, Columbia University School of Nursing, New York City, New York, USA D. Scott Batey, PhD, MSW, is a Professor at Tulane University School of Social Work, New Orleans, Louisiana, USA Asa Radix, MD, PhD, MPH, FACP, is the Executive Vice President, Callen-Lorde, New York City, New York, USA Uri Belkind, MD, MS, FAAP, AAHIVS, is the Associate Director of Medicine for Adolescent Medicine, Callen-Lorde, New York City, New York, USA Mary Tanner, MD, FAAP, was the Lead Project Officer, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Carla Galindo, MPH, CHES, is Co-Project Officer, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Stephen Ferrara, DNP, FNP, FAANP, FAAN, is a Professor of Nursing, Columbia University School of Nursing, New York City, New York, USA Corilyn Ott, PhD, is a Research Assistant, University of Alabama at Birmingham, School of Nursing and School of Medicine, Birmingham, Alabama, USA Rebecca Schnall, PhD, MPH, RN-BC, FAAN, is a Mary Dickey Lindsay Professor of Disease Prevention and Health Promotion and Associate Dean of Faculty Development, Columbia University School of Nursing, New York City, New York, USA
Carla Galindo Emma Sophia Kay, PhD, MSW, is an Associate Professor, University of Alabama at Birmingham, School of Nursing, Birmingham, Alabama, USA Shivesh Shourya, BS, is a graduate student, Yale University School of Public Health, New Haven, Connecticut, USA Maeve Brin, BA, is an Assistant Manager, Columbia University School of Nursing, New York City, New York, USA D. Scott Batey, PhD, MSW, is a Professor at Tulane University School of Social Work, New Orleans, Louisiana, USA Asa Radix, MD, PhD, MPH, FACP, is the Executive Vice President, Callen-Lorde, New York City, New York, USA Uri Belkind, MD, MS, FAAP, AAHIVS, is the Associate Director of Medicine for Adolescent Medicine, Callen-Lorde, New York City, New York, USA Mary Tanner, MD, FAAP, was the Lead Project Officer, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Carla Galindo, MPH, CHES, is Co-Project Officer, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Stephen Ferrara, DNP, FNP, FAANP, FAAN, is a Professor of Nursing, Columbia University School of Nursing, New York City, New York, USA Corilyn Ott, PhD, is a Research Assistant, University of Alabama at Birmingham, School of Nursing and School of Medicine, Birmingham, Alabama, USA Rebecca Schnall, PhD, MPH, RN-BC, FAAN, is a Mary Dickey Lindsay Professor of Disease Prevention and Health Promotion and Associate Dean of Faculty Development, Columbia University School of Nursing, New York City, New York, USA
Stephen Ferrara Emma Sophia Kay, PhD, MSW, is an Associate Professor, University of Alabama at Birmingham, School of Nursing, Birmingham, Alabama, USA Shivesh Shourya, BS, is a graduate student, Yale University School of Public Health, New Haven, Connecticut, USA Maeve Brin, BA, is an Assistant Manager, Columbia University School of Nursing, New York City, New York, USA D. Scott Batey, PhD, MSW, is a Professor at Tulane University School of Social Work, New Orleans, Louisiana, USA Asa Radix, MD, PhD, MPH, FACP, is the Executive Vice President, Callen-Lorde, New York City, New York, USA Uri Belkind, MD, MS, FAAP, AAHIVS, is the Associate Director of Medicine for Adolescent Medicine, Callen-Lorde, New York City, New York, USA Mary Tanner, MD, FAAP, was the Lead Project Officer, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Carla Galindo, MPH, CHES, is Co-Project Officer, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Stephen Ferrara, DNP, FNP, FAANP, FAAN, is a Professor of Nursing, Columbia University School of Nursing, New York City, New York, USA Corilyn Ott, PhD, is a Research Assistant, University of Alabama at Birmingham, School of Nursing and School of Medicine, Birmingham, Alabama, USA Rebecca Schnall, PhD, MPH, RN-BC, FAAN, is a Mary Dickey Lindsay Professor of Disease Prevention and Health Promotion and Associate Dean of Faculty Development, Columbia University School of Nursing, New York City, New York, USA
Corilyn Ott Emma Sophia Kay, PhD, MSW, is an Associate Professor, University of Alabama at Birmingham, School of Nursing, Birmingham, Alabama, USA Shivesh Shourya, BS, is a graduate student, Yale University School of Public Health, New Haven, Connecticut, USA Maeve Brin, BA, is an Assistant Manager, Columbia University School of Nursing, New York City, New York, USA D. Scott Batey, PhD, MSW, is a Professor at Tulane University School of Social Work, New Orleans, Louisiana, USA Asa Radix, MD, PhD, MPH, FACP, is the Executive Vice President, Callen-Lorde, New York City, New York, USA Uri Belkind, MD, MS, FAAP, AAHIVS, is the Associate Director of Medicine for Adolescent Medicine, Callen-Lorde, New York City, New York, USA Mary Tanner, MD, FAAP, was the Lead Project Officer, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Carla Galindo, MPH, CHES, is Co-Project Officer, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Stephen Ferrara, DNP, FNP, FAANP, FAAN, is a Professor of Nursing, Columbia University School of Nursing, New York City, New York, USA Corilyn Ott, PhD, is a Research Assistant, University of Alabama at Birmingham, School of Nursing and School of Medicine, Birmingham, Alabama, USA Rebecca Schnall, PhD, MPH, RN-BC, FAAN, is a Mary Dickey Lindsay Professor of Disease Prevention and Health Promotion and Associate Dean of Faculty Development, Columbia University School of Nursing, New York City, New York, USA
Rebecca Schnall Emma Sophia Kay, PhD, MSW, is an Associate Professor, University of Alabama at Birmingham, School of Nursing, Birmingham, Alabama, USA Shivesh Shourya, BS, is a graduate student, Yale University School of Public Health, New Haven, Connecticut, USA Maeve Brin, BA, is an Assistant Manager, Columbia University School of Nursing, New York City, New York, USA D. Scott Batey, PhD, MSW, is a Professor at Tulane University School of Social Work, New Orleans, Louisiana, USA Asa Radix, MD, PhD, MPH, FACP, is the Executive Vice President, Callen-Lorde, New York City, New York, USA Uri Belkind, MD, MS, FAAP, AAHIVS, is the Associate Director of Medicine for Adolescent Medicine, Callen-Lorde, New York City, New York, USA Mary Tanner, MD, FAAP, was the Lead Project Officer, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Carla Galindo, MPH, CHES, is Co-Project Officer, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Stephen Ferrara, DNP, FNP, FAANP, FAAN, is a Professor of Nursing, Columbia University School of Nursing, New York City, New York, USA Corilyn Ott, PhD, is a Research Assistant, University of Alabama at Birmingham, School of Nursing and School of Medicine, Birmingham, Alabama, USA Rebecca Schnall, PhD, MPH, RN-BC, FAAN, is a Mary Dickey Lindsay Professor of Disease Prevention and Health Promotion and Associate Dean of Faculty Development, Columbia University School of Nursing, New York City, New York, USA

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Jones J, Siegler AJ, Glick JL, Lucas IL, Sullivan PS, Sarkar S, Ragone L, Rawlings MK, Vannappagari V, Sanchez T. Brief Report: Potential Gains in PrEP Coverage and Effect on Racial Disparities After Introduction of On-Demand and Long-Acting Injectable PrEP: Preferences of Men Who Have Sex With Men in the United States, 2021-2022. J Acquir Immune Defic Syndr 2025;98:429-433. [PMID: 40067782 DOI: 10.1097/qai.0000000000003602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 09/06/2024] [Indexed: 01/11/2025]

Turpin R, Camp AD, Mandell CJ, Davidson Mhonde R, Mandeville J, Smith J, Liu H, Dyer T, Mayer K, Boekeloo B. "Healthcare Doesn't Care": A Mixed-Methods Study on Healthcare Stigma and PrEP Use Among Black Sexual Minority Men. Am J Health Promot 2025:8901171251330710. [PMID: 40170576 DOI: 10.1177/08901171251330710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2025]

Abstract

BackgroundPre-exposure prophylaxis (PrEP) is a critical tool for HIV-prevention, yet PrEP uptake among Black sexual minority men (BSMM) is relatively low, despite greater HIV vulnerability. Stigma in healthcare settings can be a substantial barrier to PrEP use among BSMM, with implications for the HIV epidemic. We used a sequential explanatory mixed-methods approach to assess quantitative relationships between anticipated healthcare stigma and reduced PrEP use among BSMM, and qualitatively explore stigmatizing experiences within healthcare settings among this population.MethodsWe utilized 2 data sources. First, cross-sectional data from a pilot sample of BSMM (n = 151) was collected in late 2020 in the United States. We tested for associations between healthcare stigma and PrEP use using modified Poisson regression. Subsequently, we selected participants (n = 23) from this sample in the D.C. metropolitan area for qualitative interviews starting in 2022; we used thematic analysis to investigate forms of experienced and anticipated healthcare stigma related to PrEP use.ResultsWe found 82% lower PrEP use associated with an interquartile range increase in anticipated healthcare stigma after adjustment (aPR = 0.18, 95% CI 0.06, 0.59). Subsequently, our qualitative investigation revealed that identity-specific stigma, negative socioeconomic assumptions, and assumptions of sexual risk were prevalent themes in the healthcare stigmatization experienced by BSMM. Identity-based and socioeconomic stigma were heavily interlinked due to longstanding structural racism and homophobia. Assumptions of sexual risk were particularly complex.ConclusionWe discovered a significant negative relationship between anticipated healthcare stigma and PrEP use, further elucidated in our qualitative findings. This builds upon our previous work exploring intracommunity PrEP stigma among BSMM. Healthcare stigma serves as an additional obstacle to accessing PrEP for BSMM. This highlights its importance as a target for provider-level health equity policy and research interventions. Future research exploring this stigma in specific healthcare settings is recommended.

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Alohan DI, Chandra C, Young HN, Quamina A, Holland DP, Crawford ND. Exploring Willingness to Use Long-Acting Injectable PrEP Among Sexual and Gender Minoritized People Accessing Pharmacies. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2025;37:107-125. [PMID: 40323669 DOI: 10.1521/aeap.2025.37.2.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2025]

DiFranceisco W, Quinn K, Walsh JL, Kelly JA, Amirkhanian YA, McAuliffe TL, Pearson B, Brown KD. Differences Among Current Pre-exposure Prophylaxis (PrEP) Users, Former Users, and Nonusers in a Community Sample in Two Midwestern U.S. Cities: Implications for Interventions to Promote PrEP Uptake and Adherence. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2025;37:160-172. [PMID: 40323671 DOI: 10.1521/aeap.2025.37.2.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2025]

Tross S, Laschober TC, Paschen-Wolff M, Ertl M, Nelson CM, Wright L, Lancaster C, Feaster DJ, Monger M, Toal P, Fegley JP, Meche D, Hankey C, Woodhouse C, Spector A, Dresser L, Moran L, Jelstrom E, Haynes L, Shoptaw S, Hatch MA. Willingness to Use Oral and Long-Acting Injectable PrEP in Substance-Using Men who have Sex with Men (SU-MSM) in High HIV Incidence Southern U.S. Cities: A NIDA Clinical Trials Network Study. AIDS Behav 2025;29:1192-1204. [PMID: 39739284 DOI: 10.1007/s10461-024-04594-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2024] [Indexed: 01/02/2025]

Affiliation(s)

Susan Tross Columbia University Irving Medical Center, New York, NY, USA.
Tanja C Laschober University of Washington Addictions, Drug & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, Seattle, WA, USA
Margaret Paschen-Wolff Columbia University Irving Medical Center, New York, NY, USA
Melissa Ertl Present address: Department of Psychology, University of Minnesota, Minneapolis, MN, USA
C Mindy Nelson Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
Lynette Wright University of Washington Addictions, Drug & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, Seattle, WA, USA
Chloe Lancaster Department of Leadership, Policy, and Lifelong Learning, University of South Florida, Tampa, FL, USA
Daniel J Feaster Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
Mauda Monger My Brother's Keeper, Ridgeland, MS, USA Present address: Myrlie Evers-Williams Institute for the Elimination of Health Disparities, Center for HIV/AIDS Research, Education and Policy, University of Mississippi Medical Center, Jackson, MS, USA
Phil Toal Aspire Health Partners, HIV Services, Orlando, FL, USA
Joshua P Fegley Crescent Care, New Orleans, LA, USA Present address: Tulane School of Social Work, New Orleans, LA, USA
David Meche Open Health Care Clinic, Baton Rouge, LA, USA Present address: School of Social Work, Louisiana State University, Baton Rouge, LA, USA
Colby Hankey Aspire Health Partners, HIV Services, Orlando, FL, USA
Christina Woodhouse Jasmyn, Jacksonville, FL, USA
Anya Spector Stella and Charles Guttman Community College, City University of New York, New York, NY, USA
Lauren Dresser The Emmes Company, LLC, Rockville, MD, USA
Landhing Moran Center for the Clinical Trials Network, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
Eve Jelstrom The Emmes Company, LLC, Rockville, MD, USA
Louise Haynes Medical University of South Carolina, Charleston, SC, USA
Steven Shoptaw University of California at Los Angeles, Los Angeles, CA, USA
Mary A Hatch University of Washington Addictions, Drug & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, Seattle, WA, USA

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Fleary SA, Joseph PL, Rastogi S, Fenton T, Srivastava V. A Study on How Libraries Operate as Health Spaces in the United States. J Community Health 2025;50:317-334. [PMID: 39489885 DOI: 10.1007/s10900-024-01403-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2024] [Indexed: 11/05/2024]

Noh M, Mehta N, Kim C, Bond K, Threats M, Jackson JW, Nnawulezi N, Agénor M. Association Between Health Care Discrimination and Medical Mistrust Among Black Assigned Female at Birth Adults with Minoritized Sexual and Gender Identities in the United States. LGBT Health 2025. [PMID: 39911034 DOI: 10.1089/lgbt.2024.0263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2025] Open

Abstract

Purpose: Black sexually and gender minoritized (SGM) people who were assigned female at birth (AFAB) experience compounding health care inequities, barriers to equitable care, and disproportionately adverse health outcomes. Given prior literature indicating that both experienced and/or anticipated reported health care discrimination and medical mistrust may shape these health care experiences of Black SGM AFAB people, we sought to investigate the specific interplay between these two factors to bolster understanding of their relationship. Methods: In January and February 2023, we conducted a cross-sectional online survey of 156 Black SGM AFAB adults in the United States (U.S.) assessing their reported lifetime experiences of all-cause and gender-, race/ethnicity-, and weight-based discrimination in health care settings, in addition to their ratings of medical mistrust on the Medical Mistrust Index (MMI). Univariate statistics, analysis of variance, post hoc pairwise tests, and multivariable linear regression were conducted to assess measures of health care discrimination, medical mistrust, and covariates and their associations among the analytic sample (n = 130). Results: Most participants reported prior experiences of health care discrimination. Adjusting for demographic, socioeconomic, and health care factors, we identified an association between experiencing any-cause-, race/ethnicity-, or weight-based discrimination and significantly higher MMI scores. The association for gender-based discrimination was not statistically significant. Conclusion: Black SGM AFAB people who experience any-cause-, race/ethnicity-, or weight-based discrimination may be more likely to experience higher levels of medical mistrust. Identifying interventions and pathways to tackle health care discrimination and the systemic and structural drivers of medical mistrust will be critical to augmenting health care outcomes and experiences of Black SGM communities.

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Wiginton JM, Murray SM, Anderson BJ, Sey K, Ma Y, Flynn CP, German D, Higgins E, Menza TW, Orellana ER, Sanz S, Hasan NA, Al-Tayyib A, Kienzle J, Shields G, Lopez Z, Wermuth P, Baral SD. Sexual behavior stigma among cisgender gay, bisexual, and other men who have sex with men in nine NHBS cities across the United States: Burden and associations with PrEP continuum and HIV care continuum outcomes. STIGMA AND HEALTH 2025;10:95-106. [PMID: 39935519 PMCID: PMC11810123 DOI: 10.1037/sah0000495] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2025]

Janek SE, Matos LA, Hatoum S, Mulawa MI, Ledbetter L, Relf MV. Racism, homophobia, and the sexual health of young Black men who have sex with men in the United States: A systematic review. PLoS One 2025;20:e0316532. [PMID: 39820894 PMCID: PMC11737682 DOI: 10.1371/journal.pone.0316532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 12/12/2024] [Indexed: 01/19/2025] Open

Okafor CN, Yoon J, Heads A, Schmitz J. Understanding Intentions to Discuss Long-Acting Injectable Pre-Exposure Prophylaxis with Healthcare Providers Among Black and Hispanic Gay and Bisexual Men in Texas. J Int Assoc Provid AIDS Care 2025;24:23259582251336662. [PMID: 40304620 PMCID: PMC12046173 DOI: 10.1177/23259582251336662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Revised: 03/05/2025] [Accepted: 04/04/2025] [Indexed: 05/02/2025] Open

John SA, Walsh JL, Doherty RM, Rine SR, O’Neil AM, Dang M, Quinn KG. Determinants of Potential HIV Vaccine Uptake Among Young Sexual Minoritized Men 17-24 Year Old. J Acquir Immune Defic Syndr 2024;97:482-488. [PMID: 39171988 PMCID: PMC11723810 DOI: 10.1097/qai.0000000000003517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 07/16/2024] [Indexed: 08/23/2024]

Gomillia CE, Burns PA, Xavier Hall CD, Beach LB. The Association of Depression, Social Determinants and PrEP Uptake Among Black Sexual Minority Men in the Deep South. J Racial Ethn Health Disparities 2024;11:3401-3409. [PMID: 37702972 DOI: 10.1007/s40615-023-01793-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 09/01/2023] [Accepted: 09/05/2023] [Indexed: 09/14/2023]

Young LE. Effects of Online Friendships on Safer Sex Communication and Behavior among Black Sexual Minority Men: A Study of Network Exposure. HEALTH COMMUNICATION 2024;39:2419-2430. [PMID: 37712151 PMCID: PMC10940198 DOI: 10.1080/10410236.2023.2258309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]

Ross MH, Neish C, Setchell J. "It's just as remarkable as being left-handed, isn't it?": exploring normativity through Australian physiotherapists' perspectives of working with LGBTQIA+ patients. Physiother Theory Pract 2024;40:2309-2320. [PMID: 37519133 DOI: 10.1080/09593985.2023.2241079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 08/01/2023]

Abstract

INTRODUCTION

Individuals identifying as lesbian, gay, bisexual, transgender, queer, intersex, asexual and other related identities (LGBTQIA+) experience challenges with healthcare, including physiotherapy. To understand potential contributions to poor experiences, this study explored physiotherapists' experiences and perspectives about working with members of LGBTQIA+ communities.

METHODS

This study employed a qualitative research design, suitable for exploring the experiences and perspectives of individuals within the physiotherapy context. The sample consisted of physiotherapists working in Australia who participated in a larger survey study. Data were collected via semi-structured interviews which were audio-recorded and transcribed verbatim. Data analysis was conducted using a relativistic and queer theoretical framework with a reflexive thematic approach.

RESULTS

Eighteen physiotherapists with diverse sexual orientations participated in the interviews. While all participants identified as women or men, not all used binary gender pronouns. Five key themes were developed: 1) "anti-discrimination" regarding choice of language and providing safe environments; 2) "current and historical discrimination" against LGBTQIA+ individuals; 3) "taking an equality approach" when working with LGBTQIA+ patients; 4) "knowledge of LGBTQIA+ health" in a broad sense and specifically with transgender and gender-diverse people; and 5) "managing own reactions" with respect to individual biases and discomfort.

CONCLUSION

Underpinning all themes was the overarching concept of cis/hetero/endonormativity. Assuming normativity when working with LGBTQIA+ patients, is likely to have negative effects on patients' mental health, the therapeutic relationship and quality of care. In order to improve diversity, safety, inclusion and equity of care for LGBTQIA+ individuals, it is vital that normativity within physiotherapy is challenged.

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Quinn KG, Randall L, Petroll AE, John SA, Wesp L, Amirkhanian Y, Kelly JA. "That's My Girl; I love her": The Promise of Compassionate, Inclusive Healthcare for Black Transgender Women to Support PrEP Use. AIDS Behav 2024;28:2899-2909. [PMID: 38809388 PMCID: PMC11627066 DOI: 10.1007/s10461-024-04370-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2024] [Indexed: 05/30/2024]

Rodrigues SS, de Andrade AFSM, da Silva K, da Silva ÂM, Martins-Filho PR. Demographic, socioeconomic, and health structure factors associated with the use of HIV pre-exposure prophylaxis in Brazil: A nationwide ecological study. Int J STD AIDS 2024;35:721-726. [PMID: 38720580 DOI: 10.1177/09564624241252186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]

Hascher K, Jaiswal J, LoSchiavo C, Ezell J, Duffalo D, Greene RE, Cox A, Burton WM, Griffin M, John T, Grin B, Halkitis PN. Lack of Informed and Affirming Healthcare for Sexual Minority Men: A Call for Patient-Centered Care. J Gen Intern Med 2024;39:2023-2032. [PMID: 38308157 PMCID: PMC11306825 DOI: 10.1007/s11606-024-08635-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 01/16/2024] [Indexed: 02/04/2024]

Abstract

BACKGROUND

Sexual minority men (SMM) face severe health inequities alongside negative experiences that drive avoidance of medical care. Understanding how SMM experience healthcare is paramount to improving this population's health. Patient-centered care, which emphasizes mutual respect and collaboration between patients and providers, may alleviate the disparaging effects of the homophobia that SMM face in healthcare settings.

OBJECTIVE

To explore how SMM perceive their experiences with healthcare providers and how care can most effectively meet their needs.

DESIGN

Semi-structured qualitative interviews focused on healthcare experiences, pre-exposure prophylaxis (PrEP), and HIV-related beliefs were conducted between July and November 2018.

PARTICIPANTS

The study included a sample of 43 young adult SMM (ages 25-27), representing diverse socioeconomic, racial, and ethnic backgrounds, in New York City.

APPROACH

Researchers utilized a multiphase, systematic coding method to identify salient themes in the interview transcripts.

KEY RESULTS

Analyses revealed three main themes: (1) SMM perceived that their clinicians often lack adequate skills and knowledge required to provide care that considers participants' identities and behaviors; (2) SMM desired patient-centered care as a way to regain agency and actively participate in making decisions about their health; and (3) SMM felt that patient-centered care was more common with providers who were LGBTQ-affirming, including many who felt that this was especially true for LGBTQ-identified providers.

CONCLUSIONS

SMM expressed a clear and strong desire for patient-centered approaches to care, often informed by experiences with healthcare providers who were unable to adequately meet their needs. However, widespread adoption of patient-centered care will require improving education and training for clinicians, with a focus on LGBTQ-specific clinical care and cultural humility. Through centering patients' preferences and experiences in the construction of care, patient-centered care can reduce health inequities among SMM and empower healthcare utilization in a population burdened by historic and ongoing stigmatization.

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Affiliation(s)

Kevin Hascher Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
Jessica Jaiswal Department of Family and Community Medicine, University of Alabama, Birmingham School of Medicine, Birmingham, AL, 35294, USA. Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, 06510, USA. Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), Rutgers School of Public Health, Newark, NJ, 07102, USA. Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
Caleb LoSchiavo Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), Rutgers School of Public Health, Newark, NJ, 07102, USA Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, 08854, USA
Jerel Ezell Department of Community Health Sciences, UC Berkeley, Berkeley, CA, 94720, USA Center for Cultural Humility, UC Berkeley, Berkeley, CA, 94720, USA
Danika Duffalo School of Medicine, Creighton University, Phoenix, AZ, USA
Richard E Greene Department of Medicine, New York University Grossman School of Medicine, New York, NY, 10001, USA
Amanda Cox Culverhouse College of Business, University of Alabama, Tuscaloosa, AL, USA
Wanda M Burton Capstone College of Nursing, University of Alabama, Tuscaloosa, AL, 35401, USA
Marybec Griffin Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, 08854, USA
Tejossy John Department of Family and Community Medicine, University of Alabama, Birmingham School of Medicine, Birmingham, AL, 35294, USA
Benjamin Grin Department of Primary Care, Kansas City University College of Osteopathic Medicine, Kansas City, MO, 64106, USA
Perry N Halkitis Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), Rutgers School of Public Health, Newark, NJ, 07102, USA Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, 08854, USA Department of Urban-Global Public Health, Rutgers School of Public Health, Newark, NJ, 07102, USA

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Kelly JA, Walsh JL, DiFranceisco WJ, Amirkhanian YA, Quinn K, Brown KD, Pearson B, Foster J, Rosado AN, McAuliffe TL. Factors associated with PrEP use in a community sample of African American men who have sex with men (MSM) and transgender women (TGW) in the United States Midwest. AIDS Care 2024;36:101-108. [PMID: 38311890 PMCID: PMC11283983 DOI: 10.1080/09540121.2024.2308743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/10/2024] [Indexed: 02/06/2024]

Flores RA, Wilkerson JM, Travis A, Almirol E, Washington D, Weaver L, Liebert C, Chiao E, Hazra A, Nyitray AG. Men who have sex with men experience low anxiety and few barriers to performing anal self or companion examinations: a qualitative study of the Prevent Anal Cancer Palpation Study. CULTURE, HEALTH & SEXUALITY 2024;26:920-935. [PMID: 37812464 PMCID: PMC11001786 DOI: 10.1080/13691058.2023.2263500] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 09/22/2023] [Indexed: 10/10/2023]

Dangerfield Ii DT, Anderson JN, Wylie C, Bluthenthal R, Beyrer C, Farley JE. A Multicomponent Intervention (POSSIBLE) to Improve Perceived Risk for HIV Among Black Sexual Minority Men: Feasibility and Preliminary Effectiveness Pilot Study. JMIR Hum Factors 2024;11:e54739. [PMID: 38861707 PMCID: PMC11200034 DOI: 10.2196/54739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/17/2024] [Accepted: 04/22/2024] [Indexed: 06/13/2024] Open

Abstract

BACKGROUND

Increased pre-exposure prophylaxis (PrEP) use is urgently needed to substantially decrease HIV incidence among Black sexual minority men. Low perceived risk for HIV (PRH) is a key unaddressed PrEP barrier for Black sexual minority men. Peers and smartphone apps are popular intervention tools to promote community health behaviors, but few studies have used these together in a multicomponent strategy. Therefore, we designed a multicomponent intervention called POSSIBLE that used an existing smartphone app called PrEPme (Emocha Mobile Health, Inc) and a peer change agent (PCA) to increase PRH as a gateway to PrEP.

OBJECTIVE

This paper aims to describe the feasibility and preliminary impact of POSSIBLE on PRH and willingness to accept a PrEP referral among Black sexual minority men.

METHODS

POSSIBLE was a theoretically guided, single-group, 2-session pilot study conducted among Black sexual minority men from Baltimore, Maryland between 2019 and 2021 (N=69). POSSIBLE integrated a PCA and the PrEPme app that allows users to self-monitor sexual risk behaviors and chat with the in-app community health worker to obtain PrEP service information. PRH was assessed using the 8-item PRH scale before and after baseline and follow-up study visits. At the end of each study visit, the PCA referred interested individuals to the community health worker to learn more about PrEP service options.

RESULTS

The average age of participants was 32.5 (SD 8.1, range 19-62) years. In total, 55 (80%) participants were retained for follow-up at month 1. After baseline sessions, 29 (42%) participants were willing to be referred to PrEP services, 20 (69%) of those confirmed scheduled appointments with PrEP care teams. There were no statistically significant differences in PRH between baseline and follow-up visits (t122=-1.36; P=.17).

CONCLUSIONS

We observed no statistically significant improvement in PRH between baseline and month 1. However, given the high retention rate and acceptability, POSSIBLE may be feasible to implement. Future research should test a statistically powered peer-based approach on PrEP initiation among Black sexual minority men.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04533386; https://clinicaltrials.gov/study/NCT04533386.

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Psaros C, Hill-Rorie J, Quint M, Horvitz C, Dormitzer J, Biello KB, Krakower DS, Safren SA, Mimiaga MJ, Sullivan P, Hightow-Weidman LB, Mayer KH. A qualitative exploration of how to support PrEP adherence among young men who have sex with men. AIDS Care 2024;36:732-743. [PMID: 37748111 PMCID: PMC10961251 DOI: 10.1080/09540121.2023.2240070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/18/2023] [Indexed: 09/27/2023]

Abstract

New HIV infections disproportionately affect young men who have sex with men (YMSM). PrEP is effective in preventing HIV acquisition; however, adherence is critical and is often suboptimal among YMSM. Interventions addressing the unique PrEP adherence challenges faced by YMSM are needed. We conducted qualitative interviews with 20 HIV-negative, YMSM (ages 15-24) with a PrEP indication and 11 healthcare professionals to inform adaption of a PrEP adherence intervention (Life-Steps for PrEP) for YMSM. We explored environmental, healthcare, and individual factors influencing uptake, adherence, attitudes, and perspectives (including desired modifications) on the Life-Steps intervention. Interviews were analyzed using content analysis. Of YMSM study participants (mean age 21.6) 55% were White, 15% Hispanic, and 5% Black. Most YMSM were PrEP-experienced (70%). Healthcare professionals (6 prescribers, 1 nurse, 2 health educators, 2 other/unspecified) averaged 6.9 years of experience caring for YMSM. All described stigma as a barrier to PrEP; YMSM expressed concern around being perceived as "risky" and concern about inadvertent PrEP disclosure if family/friends found their medication, or if parental insurance was used. Difficulty with planning for potential adherence challenges were identified by both groups. YMSM highlighted benefits of a nurse-led intervention (i.e., adding "legitimacy"), but stressed need for nonjudgmental, "savvy" interventionists. YMSM expressed a desire for comprehensive YMSM-specific sexual health information. These findings informed modification and expansion of Life-Steps content. Results highlight key potential barriers, many of which center around privacy. Content that addresses PrEP stigma, disclosing PrEP use, navigating insurance, and planning ahead in a nonjudgmental environment by trusted providers emerged as important components of a YMSM-focused delivery of Life-Steps for PrEP.

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Affiliation(s)

Christina Psaros Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States The Fenway Institute, Fenway Health, Boston, MA, United States
Jonathan Hill-Rorie The Fenway Institute, Fenway Health, Boston, MA, United States
Meg Quint The Fenway Institute, Fenway Health, Boston, MA, United States Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Boston, Massachusetts, United States
Casey Horvitz Behavior and Technology Lab, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
Julian Dormitzer The Fenway Institute, Fenway Health, Boston, MA, United States
Katie B. Biello The Fenway Institute, Fenway Health, Boston, MA, United States Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI, United States Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, RI, United States Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States
Douglas S. Krakower The Fenway Institute, Fenway Health, Boston, MA, United States Department of Medicine, Harvard Medical School, Boston, MA, United States Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA, United States
Steven A. Safren Department of Psychology, University of Miami, Coral Gables, FL, United States
Matthew J. Mimiaga The Fenway Institute, Fenway Health, Boston, MA, United States UCLA Center for LGBTQ+ Advocacy, Research & Health, Los Angeles, CA, United States Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, United States Department of Psychiatry & Biobehavioral Sciences, UCLA David Geffen School of Medicine, Los Angeles, CA, United States
Patrick Sullivan Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
Lisa B. Hightow-Weidman Institute on Digital Health and Innovation, College of Nursing, Florida State University, Tallahassee, FL, United States
Kenneth H. Mayer The Fenway Institute, Fenway Health, Boston, MA, United States Department of Medicine, Harvard Medical School, Boston, MA, United States Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA, United States

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Dangerfield Ii DT, Anderson JN. A Scripted, PrEP-Using Peer Change Agent Improves Perceived Risk for HIV and Willingness to Accept Referrals Quickly Among Black Sexual Minority Men: Preliminary Findings from POSSIBLE. AIDS Behav 2024;28:2156-2165. [PMID: 38551719 DOI: 10.1007/s10461-024-04313-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2024] [Indexed: 09/18/2024]

Okafor CN, Eaton L, Watson R. Willingness to Use Long-Acting Injectable PrEP Among PrEP Naïve Black and Hispanic Sexual Gender Minority Persons. AIDS Behav 2024;28:2166-2174. [PMID: 38526639 DOI: 10.1007/s10461-024-04314-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2024] [Indexed: 03/27/2024]

McCauley PS, Morgan E, Caba AE, Renley BM, Eaton LA, Watson RJ. Perceptions of bias in HIV prevention services, happiness with social support, and anticipated PrEP stigma among Black and Latine/x sexual and gender diverse individuals. AIDS Care 2024;36:682-691. [PMID: 38451740 DOI: 10.1080/09540121.2024.2326126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 02/26/2024] [Indexed: 03/09/2024]

DeBrosse R, Mao X, Anand NS, Mullins A, Singh P, Sorcher JL, Jung J, Sanders RA, Beach MC, Pahwa AK, Golden WC, Fields EL. Evaluating the Impact of an Adolescent Sexuality Education Workshop on Medical Student Communication in an Objective Structured Clinical Examination. J Adolesc Health 2024;74:1026-1032. [PMID: 38323963 DOI: 10.1016/j.jadohealth.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 10/27/2023] [Accepted: 12/12/2023] [Indexed: 02/08/2024]

Chang K, D'Anna LH, Owens J, Wood J. The Effects of Previous Experiences of Healthcare Discrimination on HIV Intervention Outcomes. AIDS Behav 2024;28:1741-1751. [PMID: 38367163 DOI: 10.1007/s10461-024-04267-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2024] [Indexed: 02/19/2024]

Collins L, Barnes SL, Heffernan K, Lyew D. Knowledge about HIV-Related Services Among Young Blacks with Diverse Sexual Identities: an Intra-racial Analysis. J Racial Ethn Health Disparities 2024;11:1056-1066. [PMID: 38315291 DOI: 10.1007/s40615-023-01585-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/23/2023] [Accepted: 03/31/2023] [Indexed: 02/07/2024]

Craig A, Walsh J, Quinn K. Intersectional Microaggressions, Sexual Identity Concealment, and Mental Health of Young Black Sexual Minority Men and Transgender Women. ARCHIVES OF SEXUAL BEHAVIOR 2024;53:1245-1254. [PMID: 38114872 PMCID: PMC11665803 DOI: 10.1007/s10508-023-02777-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 12/21/2023]

James D. Initial Development and Validation of the Brief Internalized Heterosexist Racism Scale for Gay and Bisexual Black Men: A Measure of Internalized Heterosexist Racism. ARCHIVES OF SEXUAL BEHAVIOR 2024;53:1307-1325. [PMID: 38388762 PMCID: PMC10955034 DOI: 10.1007/s10508-023-02805-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 12/29/2023] [Accepted: 12/30/2023] [Indexed: 02/24/2024]

Abstract

We introduce internalized heterosexist racism (IHR), or the internalization of damaging stereotypes, harmful beliefs, and negative attitudes about being a sexual minority person of color. We also present the initial development and validation of the Brief Internalized Heterosexist Racism Scale for gay and bisexual Black men (IHR-GBBM), a unidimensional, 10-item measure of IHR. Exploratory factor analyses on an internet-obtained sample of gay and bisexual Black men (N = 312; Mean age = 30.36 years) show that the IHR-GBBM had evidence of good internal consistency, and good convergent, discriminant, concurrent, and incremental validity. The IHR-GBBM was positively correlated with internalized racism, internalized heterosexism, and discrimination (racist, heterosexist). IHR was also negatively correlated with race stigma consciousness, weakly positively correlated with sexual identity stigma consciousness, but not correlated with either race identity, sexual identity, or social desirability. Hierarchical regressions showed that the IHR-GBBM explained an additional variance of 2.8% and 3.1% in anxiety symptoms and substance use coping, respectively, after accounting for (1) sociodemographics, (2) internalized racism and internalized heterosexism, and (3) an interaction of internalized racism and internalized heterosexism. Older participants and those who were "out" about their sexual identity reported lower IHR. Those who did not know/want to report their HIV status reported greater IHR. Results revealed no sexual identity, sexual position, relationship status, income, education, or employment status differences in IHR. We hope the development of the IHR-GBBM spurs future research on predictors and consequences of IHR. We discuss limitations and implications for the future study of internalized heterosexist racism.

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Turpin RE, Camp AD, Mandell CJ, Mhonde RRD, Dyer TV, Mayer KH, Liu H, Coates T, Boekeloo B. Black Sexual Minority Men's Experiences in MPowerment Interventions: Implications for HIV Prevention. Int J Behav Med 2024:10.1007/s12529-024-10275-5. [PMID: 38499962 PMCID: PMC11563193 DOI: 10.1007/s12529-024-10275-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2024] [Indexed: 03/20/2024]

Heath G, Kaur K, Farrow C, Ross JDC, Clarke R. Barriers to engagement with testing for sexually transmitted infections within a UK-based young adult Black Caribbean community: a qualitative study. Sex Health 2024;21:SH23166. [PMID: 38432685 DOI: 10.1071/sh23166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 02/16/2024] [Indexed: 03/05/2024]

Hutchins F, Drey N. Influences affecting decision-making regarding use of pre-exposure prophylaxis among black men who have sex with men in the USA: a systematic review and meta-synthesis. Sex Transm Infect 2024;100:98-105. [PMID: 38148150 DOI: 10.1136/sextrans-2023-055861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 12/02/2023] [Indexed: 12/28/2023] Open

Abstract

AIM

To systematically identify, evaluate, and synthesise qualitative research examining positive and negative influences affecting decision-making behaviour among black men who have sex with men (BMSM) in the USA regarding use of pre-exposure prophylaxis (PrEP).

BACKGROUND

Used correctly, PrEP is highly efficacious in preventing HIV infection and is available via healthcare services throughout the USA. BMSM are a key target population for HIV prevention services, however their engagement with these services is low. With potential barriers to access ranging from systemic to personal, a phenomenological perspective on the influences affecting individuals' decision-making is essential, helping to better understand the needs of this target population and guide development and delivery of more effective future policy and intervention services.

DESIGN

Qualitative meta-synthesis with meta-aggregation.

DATA SOURCES

The electronic databases Medline, CINAHL, APA PsycInfo, Embase and Ovid Emcare were comprehensively searched from inception to 21 January 2022.

REVIEW METHODS

Systematic identification, quality assessment and synthesis of existing qualitative research according to protocols of meta-aggregation. This included identifying salient study findings and corroborating illustrations from the data, sorting like findings into descriptive themed categories and developing transformative synthesised statements from aggregate appraisal of category findings.

RESULTS

Seventeen studies met the inclusion criteria and were assessed to be of acceptable quality. Synthesis of study data yielded 30 categories grouped under five themes: Stigma, Discrimination, Mistrust, PrEP positivity and PrEP negativity. Twelve synthesised statements were produced to provide a summary of the results and suggest improvements to the delivery of future PrEP services and interventions.

CONCLUSION

A more targeted approach focused on advocacy and ambassadorship outside of clinical settings may be more influential in positive decision-making regarding use of PrEP in BMSM populations than relying on traditional outreach methods via institutions and their representatives where stigma, mistrust and structural inequalities perpetuate.

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Gordon J, Wongsomboon V, Alvarado Avila A, Lorenzo J, Mustanski B, Macapagal K. Experiences of Successful PrEP Uptake Among Adolescent Sexual Minority Men in the United States: A Qualitative Exploration. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2024;36:1-15. [PMID: 38349349 PMCID: PMC11376320 DOI: 10.1521/aeap.2024.36.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]

Quinn KG, Walsh JL, DiFranceisco W, Edwards T, Takahashi L, Johnson A, Dakin A, Bouacha N, Voisin DR. The Inherent Violence of Anti-Black Racism and its Effects on HIV Care for Black Sexually Minoritized Men. J Urban Health 2024;101:23-30. [PMID: 38158546 PMCID: PMC10897081 DOI: 10.1007/s11524-023-00823-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2023] [Indexed: 01/03/2024]

Glick JL, Nestadt DF, Sanchez T, Li K, Hannah M, Rawlings MK, Rinehart AR, Sarkar S, Vannappagari V. Location Preferences for Accessing Long-Acting Injectable Pre-Exposure Prophylaxis (LA-PrEP) Among Men Who Have Sex With Men (MSM) Currently on Daily Oral PrEP. J Int Assoc Provid AIDS Care 2024;23:23259582241293336. [PMID: 39698980 PMCID: PMC11788811 DOI: 10.1177/23259582241293336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 09/11/2024] [Accepted: 10/05/2024] [Indexed: 12/20/2024] Open

Turpin RE, Mandell CJ, Camp AD, Mhonde RRD, Dyer TV, Mayer KH, Liu H, Coates T, Boekeloo B. COVID-19, Vaccine Hesitancy, and HIV Pre-exposure Prophylaxis Among Black Sexual Minority Men. J Acquir Immune Defic Syndr 2023;94:387-394. [PMID: 37732879 PMCID: PMC10841093 DOI: 10.1097/qai.0000000000003305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 08/30/2023] [Indexed: 09/22/2023]

Calabrese SK, Krakower DS, Rao S, Hansen NB, Mayer KH, Magnus M, Bunting SR, Marcus JL, Dovidio JF. Acceptability and Effectiveness of a One-Hour Healthcare Provider Intervention Integrating HIV Pre-Exposure Prophylaxis and Cultural Competence Training. AIDS Behav 2023;27:3932-3940. [PMID: 37401992 PMCID: PMC10906281 DOI: 10.1007/s10461-023-04108-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2023] [Indexed: 07/05/2023]

Chan C, Mao L, Bavinton BR, Holt M, Prankumar SK, Dong K, Wark T, Chen T, Wijaya HY, Wong HTH. The impact of social connections and discrimination to HIV risk among Asian gay and bisexual men in Australia. Sex Health 2023;20:479-487. [PMID: 37743096 DOI: 10.1071/sh23036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 09/06/2023] [Indexed: 09/26/2023]

Hunter LA, Packel LJ, Chitle P, Beltran RM, Rafie S, De Martini L, Dong B, Harris O, Holloway IW, Miyashita Ochoa A, McCoy SI. Opportunities to Increase Access to HIV Prevention: Evaluating the Implementation of Pharmacist-Initiated Pre-exposure Prophylaxis in California. Open Forum Infect Dis 2023;10:ofad549. [PMID: 38023549 PMCID: PMC10651201 DOI: 10.1093/ofid/ofad549] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/01/2023] [Indexed: 12/01/2023] Open

Muraleetharan V, Brault MA. Friends as Informal Educators: The Role of Peer Relationships in Promotion of Sexual Health Services among College Students. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2023;44:29-41. [PMID: 34284679 PMCID: PMC10730011 DOI: 10.1177/0272684x211034661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]

Leonard S, Sotindjo T, Brophy J, Tan DHS, Nashid N. HIV pre-exposure prophylaxis: It is time to consider harm reduction care for adolescents in Canada. Paediatr Child Health 2023;28:338-343. [PMID: 37744752 PMCID: PMC10517249 DOI: 10.1093/pch/pxac115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 10/10/2022] [Indexed: 09/26/2023] Open

D'Amours JV. Cultural discourses and HIV/AIDS activists' meanings about PrEP. CULTURE, HEALTH & SEXUALITY 2023;25:1340-1354. [PMID: 36527448 DOI: 10.1080/13691058.2022.2156617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]

Braun RA, Erenrich RK, Coyle KK, Doan THP, Klausner JD. Effectiveness, Acceptability, and Feasibility of a Telehealth HIV Pre-Exposure Prophylaxis Care Intervention Among Young Cisgender Men and Transgender Women Who Have Sex With Men: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023;12:e47932. [PMID: 37713244 PMCID: PMC10541640 DOI: 10.2196/47932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 09/16/2023] Open

Abstract

BACKGROUND

Despite its promise for HIV prevention, the uptake of pre-exposure prophylaxis (PrEP) has been slow, and there have been substantial inequities in PrEP access. Young men who have sex with men and transgender women of color are most in need of PrEP and least likely to have that need fulfilled. PrEP telehealth care, which provides remote PrEP care via electronic communication, seems well suited to address several of the challenges of PrEP provision, including discomfort with stigmatizing and difficult-to-access health care systems, transportation challenges, and privacy concerns, and address disparities in PrEP access. Research suggests that PrEP telehealth care has promise and is a favored option for many prospective recipients of PrEP. However, despite growing attention to telehealth approaches as an avenue for increasing access to PrEP amidst the COVID-19 pandemic, there have been no published randomized controlled trials (RCTs) on PrEP telehealth care to date, making it difficult to draw strong conclusions about the advantages or disadvantages of telehealth compared with usual PrEP care. We developed PrEPTECH, a telehealth intervention that focuses specifically on alleviating issues of stigma, access, cost, and confidentiality for young people with risk factors for HIV infection who are seeking PrEP care. Leveraging data from the 2017 observational pilot study, we redesigned and enhanced PrEPTECH.

OBJECTIVE

This study aims to assess the effectiveness, acceptability, and feasibility of a telehealth HIV PrEP care intervention, PrEPTECH, in increasing PrEP uptake.

METHODS

This is the protocol for an RCT of young cisgender men and transgender women who have sex with men in 4 regions within the United States: the San Francisco Bay Area, California; Los Angeles County, California; Miami-Dade County, Florida; and Broward County, Florida. Participants in the intervention arm received access to a web-based telehealth program, PrEPTECH, which offers a fully web-based pathway to PrEP, whereas those in the control arm received access to a dynamic web page containing publicly available informational resources about PrEP. Follow-up data collection occurred at 3 and 6 months. An analysis will be conducted on outcomes, including PrEP initiation, persistence, adherence, coverage, and medication prescription, as well as PrEPTECH acceptability and feasibility.

RESULTS

The study was funded in 2019 and received institutional review board approval in 2020. The PrEPTECH intervention was developed over the next 1.5 years. Study recruitment was launched in February 2022 and completed in September 2022, with 229 participants recruited in total. Data collection was completed in April 2023.

CONCLUSIONS

The results of this RCT will offer valuable evidence regarding the effectiveness, acceptability, and feasibility of telehealth HIV PrEP care interventions among young cisgender men and transgender women who have sex with men.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04902820; https://clinicaltrials.gov/ct2/show/NCT04902820.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/47932.

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Gourab G, Sarwar G, Khan MNM, Hasan AMR, Irfan SD, Saha TK, Rahman L, Rana AKMM, Khan SI. Are we ready for a sustainable approach? A qualitative study of the readiness of the public health system to provide STI services to the key populations at risk of HIV in Bangladesh. BMC Health Serv Res 2023;23:979. [PMID: 37697263 PMCID: PMC10496154 DOI: 10.1186/s12913-023-09996-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/31/2023] [Indexed: 09/13/2023] Open

Abstract

INTRODUCTION

In Bangladesh, sexually transmitted infection (STI) services are available for all populations in public health facilities. However, STI services for key populations (KPs) at risk of HIV need specifically designed approaches that are predominantly administered to KPs through donor-supported service centers operated by non-government organizations (NGOs) and community-based organisations (CBOs). However, the steady decline in donor funding warrants a sustainable transition of STI services for the KPs into public health facilities. This article aimed to explore the service availability and readiness of public health facilities to provide STI services for the KPs.

METHODS

This qualitative study explored the service availability and readiness of public health facilities in three districts of Bangladesh by adapting the Service Availability and Readiness Assessment tool. We conducted 34 in-depth interviews,11 focus group discussions with KPs, and 29 key-informant interviews with healthcare providers, researchers, programme implementers and policy planners, in addition to series of direct observations at the public healthcare facilities. Data were analysed through thematic analysis, and categorised in relation to the WHO building blocks.

RESULTS

This study revealed that the public health system was generally not ready to serve the KPs' needs in terms of providing them with quality STI services. The 'service delivery' component, which is the most crucial facet of the public health system, was not ready to provide STI services to KPs. Findings also indicated that health workforce availability was limited in the primary and secondary healthcare layers but adequate in the tertiary layer, but needed to be oriented on providing culturally sensitised treatment. Counseling, an essential component of STI services, was neither ready nor available. However, health information systems and a few other components were partially ready, although this warrants systematic approaches to address these challenges.

CONCLUSION

The findings show that public health facilities are yet to be fully ready to render STI services to KPs, especially in terms of service delivery and human and health resources. Therefore, it is not only integral to mobilize communities towards the uptake of public health services, but health systems need to be prepared to cater to their needs.

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Andrade EA, Stoukides G, Santoro AF, Karasz A, Arnsten J, Patel VV. Individual and Health System Factors for Uptake of Pre-exposure Prophylaxis Among Young Black and Latino Gay Men. J Gen Intern Med 2023;38:2768-2774. [PMID: 37429976 PMCID: PMC10507000 DOI: 10.1007/s11606-023-08274-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 06/09/2023] [Indexed: 07/12/2023]

Tobin K, Heidari O, Volpi C, Sodder S, Duncan D. Use of geofencing interventions in population health research: a scoping review. BMJ Open 2023;13:e069374. [PMID: 37536963 PMCID: PMC10401224 DOI: 10.1136/bmjopen-2022-069374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 07/17/2023] [Indexed: 08/05/2023] Open

Abstract

OBJECTIVES

Technological advancements that use global positioning system (GPS), such as geofencing, provide the opportunity to examine place-based context in population health research. This review aimed to systematically identify, assess and synthesise the existing evidence on geofencing intervention design, acceptability, feasibility and/or impact.

DESIGN

Scoping review, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidance for reporting.

DATA SOURCES

PubMed, CINAHL, EMBASE, Web of Science, Cochrane and PsycINFO for articles in English published up to 31 December 2021.

ELIGIBILITY CRITERIA

Articles were included if geofencing was used as a mechanism for intervention delivery.

EXCLUSION CRITERIA

(1) a component or combination of GPS, geographical information system or ecological momentary assessment was used without delivery of an intervention; (2) did not include a health or health-related outcome from the geofencing intervention; or (3) was not a peer-reviewed study.

DATA EXTRACTION AND SYNTHESIS

Several researchers independently reviewed all abstracts and full-text articles for final inclusion.

RESULTS

A total of 2171 articles were found; after exclusions, nine studies were included in the review. The majority were published in 5 years preceding the search (89%). Geofences in most studies (n=5) were fixed and programmed in the mobile application carried by participants without their input. Mechanisms of geofencing interventions were classified as direct or indirect, with five studies (56%) using direct interventions. There were several different health outcomes (from smoking to problematic alcohol use) across the five studies that used a direct geofencing intervention.

CONCLUSIONS

This scoping review found geofencing to be an emerging technology that is an acceptable and feasible intervention applied to several different populations and health outcomes. Future studies should specify the rationale for the locations that are geofenced and user input. Moreover, attention to mechanisms of actions will enable scientists to understand not only whether geofencing is an appropriate and effective intervention but why it works to achieve the outcomes observed.

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Driver R, Schneider JA, Hickson DA, Timmins L, Brewer RA, Goedel WC, Duncan DT. Sexual Orientation, HIV Vulnerability-Enhancing Behaviors and HIV Status Neutral Care Among Black Cisgender Sexual Minority Men in the Deep South: The N2 Cohort Study. AIDS Behav 2023;27:2592-2605. [PMID: 36648630 PMCID: PMC11034832 DOI: 10.1007/s10461-023-03984-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2023] [Indexed: 01/18/2023]

Coukan F, Murray KK, Papageorgiou V, Lound A, Saunders J, Atchison C, Ward H. Barriers and facilitators to HIV Pre-Exposure Prophylaxis (PrEP) in Specialist Sexual Health Services in the United Kingdom: A systematic review using the PrEP Care Continuum. HIV Med 2023;24:893-913. [PMID: 37078101 DOI: 10.1111/hiv.13492] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 03/20/2023] [Indexed: 04/21/2023]