Fields Errol L, Thornton Nicole, Long Amanda, Morgan Anthony, Uzzi Mudia, Sanders Renata Arrington, Jennings Jacky M
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
J LGBT Youth. 2021;18(1):23-39. doi: 10.1080/19361653.2019.1700205. Epub 2019 Dec 17.
Young Black gay, bisexual and other men who have sex with men (YBMSM) carry a disproportionate HIV burden perpetuated by exposure to sexual networks with higher untreated HIV prevalence and incidence. In Baltimore, these sexual networks include high utilization of geosocial networking apps (GSN-apps). Our prior work suggests these apps can be important access points for targeted interventions like PrEP. To inform online PrEP outreach we explored YBMSM GSN-app users' exposure to and discussions about PrEP while navigating apps. We actively recruited YBMSM (n=17) age 18-24 from the GSN-app most frequently reported by newly diagnosed HIV-infected MSM in Baltimore. Participants were recruited through direct messaging within the GSN-app while logged-on in high HIV transmission areas. Participants completed 60-90 minute semi-structured interviews, which were analyzed using a 3-stage analytic coding strategy. While some participants had not heard of PrEP, the majority described mentions or conversations about PrEP on GSN-apps. Three themes emerged: (1) Mistrust of PrEP, (2) Association with sexual promiscuity, and (3) Concerns about lack of protection from other STIs. Proper messaging, accurate information, and education are needed to account for the negative perceptions that surround PrEP; otherwise, continued underuse among YBMSM will expand rather than reduce HIV disparities.
年轻的黑人男同性恋者、双性恋者及其他与男性发生性行为的男性（YBMSM）承受着不成比例的艾滋病毒负担，这种负担因接触艾滋病毒未治疗率和发病率较高的性网络而持续存在。在巴尔的摩，这些性网络包括对地理社交网络应用程序（GSN应用程序）的高使用率。我们之前的研究表明，这些应用程序可能是像暴露前预防（PrEP）这样的针对性干预措施的重要接入点。为了为在线PrEP外展工作提供信息，我们探讨了YBMSM中GSN应用程序用户在使用应用程序时对PrEP的接触情况以及关于PrEP的讨论。我们从巴尔的摩新诊断出感染艾滋病毒的男男性行为者最常报告的GSN应用程序中，积极招募了18至24岁的YBMSM（n = 17）。参与者是在高艾滋病毒传播地区登录GSN应用程序时，通过直接发消息招募的。参与者完成了60至90分钟的半结构化访谈，并使用三阶段分析编码策略进行了分析。虽然一些参与者从未听说过PrEP，但大多数人描述了在GSN应用程序上提到或讨论过PrEP。出现了三个主题：（1）对PrEP的不信任，（2）与性乱交的关联，以及（3）对缺乏预防其他性传播感染保护措施的担忧。需要适当的信息传递、准确的信息和教育来解决围绕PrEP的负面看法；否则，YBMSM中持续的低使用率将扩大而非缩小艾滋病毒差异。
