A lack of a perceived necessity to take PrEP, a lack of general knowledge about the drug – what it is and how it works – and discomfort in getting hold of the drug.
These are the major hindrances affecting the use of PrEP of young men who have sex with other men, according to a study – “Barriers to PrEP Uptake in Young U.K. Men Who Have Sex With Men” by Loukas Haggipavlou and Richard J. T. Hamshaw – that appeared in the Journal of Prevention and Health Promotion.
Pre-exposure prophylaxis (PrEP) refers to a pill that prevents HIV contraction in HIV-negative individuals. PrEP can be taken daily or on-demand a day before and for two days after sex. When taken as prescribed it is 99% effective at preventing HIV transmission.
Despite higher risks of contracting HIV, uptake of PrEP among young men who have sex with other men is low. And this is something that this latest study from the researchers at Bath investigated .
Following in-depth interviews done with a small sample of young men aged between 18–22, this study found that there were barriers to uptake identified by those most at risk of contracting HIV and who could benefit from the treatment. These barriers included a lack of a perceived necessity to take PrEP, a lack of general knowledge about the drug – what it is and how it works; as well as discomfort in getting hold of the drug.
Anonymous responses from participants highlighted specific challenges. For example, some men felt that taking PrEP was unnecessary:
I always just engaged in safe sex so it’s like, do I need this added preventative measure if I’m already sort of like I’m doing what I should be doing?
Others saw STI screening as a solution, without considering the possibility of contracting HIV in between testing. Participants often lacked a full picture of why and how they might use PrEP, and suggested finding it difficult to access detailed information:
I didn’t know if I really needed it, like there wasn’t really advertisements or like actual people or like poster advertisements telling me that I probably need PrEP.
Regarding access to PrEP, participants also referred to awkward consultations with GPs or sexual health clinics where requesting PrEP had a perceived stigma attached:
Being in person with them and they say something awkward, and you just have to sort of sit there and then leave awkwardly it’s a lot more intense.
The researchers’ analysis backed up a review that suggested that a large proportion of young men who could be taking PrEP are not. As such, the researchers think more could and should be done to increase access to the drug, including through the implementation of new online services and increased education.
First author Haggipavlou recommended “: “I started researching PrEP uptake after I noticed a worrying number of my LGBT+ friends were relatively unaware of the drug. Following this study, we propose “enhancing… awareness by promoting stories from PrEP users about its consumption and benefits, coupled with integrating PrEP discussions into sex education in schools. To further increase uptake amongst young men who have sex with men, we also recommend the implementation of new online services for PrEP acquisition, to simplify the process, destigmatize and increase access.”
