Author:
Hayes Rosalie,Nutland Will,Rayment Michael,Wayal Sonali,Apea Vanesa,Clarke Amanda,McOwan Alan,Sullivan Ann,Desai Monica,Jajja Andrew,Rice Brian,Horne Rob,McCormack Sheena,Gafos Mitzy
Abstract
AbstractGay, bisexual, and other men who have sex with men (GBMSM) experience a high prevalence of psychosocial health problems, such as harmful substance use and depression, as well as being disproportionately affected by HIV. HIV Pre-Exposure Prophylaxis (PrEP) may provide psychosocial benefits beyond its intended purpose of reducing HIV infection. We explore the psychosocial impact of oral PrEP use on gay men in England using qualitative data from the PROUD study. From February 2014 to January 2016, semi-structured in-depth interviews were conducted with 40 gay men and one trans woman. Participants were purposively recruited based on trial arm allocation, adherence, and sexual risk behaviours. By removing HIV risk from sex, PrEP improves users’ wellbeing by reducing HIV-related anxiety and internalised stigma and increasing HIV prevention self-efficacy, sexual pleasure, and intimacy. In turn, these psychological changes may influence behaviour in the form of greater sexual freedom, reduced harmful drug use, and more protective sexual health behaviours. However, PrEP may create internal conflict for some gay men, due to its disruption of social norms around condom use and its perceived influence on their sexual behaviour leading to reduced condom self-efficacy. These findings provide a baseline of PrEP’s psychosocial impact amongst some of the first PrEP users in England and supports calls to consider the psychosocial impact of PrEP in prescribing guidelines.
Funder
Public Health England
NIHR Clinical Research Network, United Kingdom
Medical Research Council Clinical Trials Unit, United Kingdom
Gilead Sciences
Medical Research Council
Publisher
Springer Science and Business Media LLC
Subject
Pharmacology (medical),Virology,Molecular Medicine
Reference58 articles.
1. King M, Semlyen J, Tai SS, Killaspy H, Osborn D, Popelyuk D, et al. A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry. 2008;8(1):70.
2. Wittgens C, Fischer MM, Buspavanich P, Theobald S, Schweizer K, Trautmann S. Mental health in people with minority sexual orientations: a meta-analysis of population-based studies. Acta Psychiatrica Scandinavica. 2022;145(4):357–72.
3. Edwards K, Sylaska K, Neal A. Intimate Partner violence among sexual minority populations: a critical review of the literature and agenda for Future Research. Psychol Violence. 2015;5:112–21.
4. Frost DM, Meyer IH. Minority stress theory: application, critique, and continued relevance. Curr Opin Psychol. 2023;51:101579.
5. European Centre for Disease Prevention and Control and WHO Regional Office for Europe. HIV/AIDS surveillance in Europe 2021–2020 data. Copenhagen: WHO Regional Office for Europe. ; 2021 [Available from: https://www.ecdc.europa.eu/en/publications-data/hiv-aids-surveillance-europe-2021-2020-data] (Accessed 21 April 2022).