Department of Sociomedical Sciences, Irving Medical Center, Mailman School of Public Health, Columbia University, 722 West 168th Street 9th Fl., New York, NY, 10032, USA.
Department of Population Health Sciences, College of Medicine, University of Central Florida, Orlando, FL, USA.
AIDS Behav. 2022 May;26(5):1572-1586. doi: 10.1007/s10461-021-03510-7. Epub 2021 Oct 27.
Though barriers to HIV pre-exposure prophylaxis (PrEP) uptake among gay, bisexual, and other men who have sex with men (MSM) have received substantial research attention, less is known about what factors may be affecting PrEP uptake among male sex workers (MSWs), a population at high risk of HIV. This paper presents qualitative findings regarding why a subsample of MSM engaged in exchange sex (receiving money, drugs, shelter, or other goods in exchange for sex) with partners they met on dating/hookup websites and apps had never used PrEP. Analysis revealed several barriers to PrEP uptake including lack of awareness and knowledge about PrEP, scientific and medical concerns, issues related to individual risk perception and beliefs/preferences about risk management, practical and logistical barriers, and provider-level barriers. Nuances to these barriers are discussed, particularly as they relate to the specific type of sex work participants were engaged in. Implications for interventions are also discussed.
尽管男同性恋者、双性恋者和其他与男性发生性关系的男性（MSM）获得 HIV 暴露前预防（PrEP）的障碍受到了大量研究关注，但对于可能影响高 HIV 风险人群男性性工作者（MSW）接受 PrEP 的因素知之甚少。本文介绍了关于为什么参与性交易（用钱、毒品、住所或其他物品换取性）的 MSM 亚组从未使用过 PrEP 的原因的定性研究结果，他们与在约会/ hookup 网站和应用程序上遇到的伴侣。分析揭示了 PrEP 采用的几个障碍，包括对 PrEP 的缺乏认识和了解、科学和医学方面的担忧、与个人风险感知和风险管理的信念/偏好相关的问题、实际和后勤方面的障碍以及提供者层面的障碍。讨论了这些障碍的细微差别，特别是与参与者从事的特定类型性工作相关的障碍。还讨论了对干预措施的影响。
