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Editorial
. 2016 Sep;10(5):353-8.
doi: 10.1177/1557988316658288. Epub 2016 Jul 7.

Preexposure Prophylaxis and Patient Centeredness: A Call for Holistically Protecting and Promoting the Health of Gay Men

Jonathan M Snowden  1 , Maria I Rodriguez  2 , Skyler D Jackson  3 , Julia L Marcus  4
Affiliations
Editorial

Preexposure Prophylaxis and Patient Centeredness: A Call for Holistically Protecting and Promoting the Health of Gay Men

Jonathan M Snowden et al. Am J Mens Health. 2016 Sep.

Abstract

Preexposure prophylaxis has transformed HIV prevention, becoming widespread in communities of gay and bisexual men in the developed world in a short time. There is a broad concern that preexposure prophylaxis will discourage condom use among gay men (i.e., "risk compensation"). This commentary argues for broadening the focus on gay men's health beyond sexual health to address the holistic health and well-being of gay men. Gay men may benefit from being offered candid, nonjudgmental health promotion/HIV prevention messages not requiring condom use for anal sex. Lessons can be drawn from the family planning movement, which has undergone a similar shift in focus. The principle of patient centeredness supports such a shift in gay men's health toward the goal of providing men with the knowledge to evaluate various prevention approaches according to the specifics of their life circumstances and health needs. Bringing more nuance to discussions of sexual risk and sexual pleasure could facilitate more universally healthy attitudes regarding sex among gay men, in turn enabling healthier decisions more compatible with men's own values and preferences.

Keywords: HIV/AIDS; gay; risk factors; sexual health; sexually transmitted diseases/infections.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: JLM is supported by a research grant from Kaiser Permanente Northern California Community Benefit (Grant Number CN-14-2036-H) and has been supported by a research grant to her institution from Merck. All other authors have no competing interests to declare.

References

    1. Andriote J.-M. (1999). Victory deferred: How AIDS changed gay life in America. Chicago, IL: University of Chicago Press.
    1. Baeten J. M., Donnell D., Ndase P., Mugo N. R., Campbell J. D., Wangisi J., . . . Celum C. (2012). Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. New England Journal of Medicine, 367, 399-410. - PMC - PubMed
    1. Bauermeister J. A., Carballo-Dieguez A., Ventuneac A., Dolezal C. (2009). Assessing motivations to engage in intentional condomless anal intercourse in HIV risk contexts (“bareback sex”) among men who have sex with men. AIDS Education and Prevention, 21, 156-168. - PMC - PubMed
    1. Boehmer U. (2002). Twenty years of public health research: Inclusion of lesbian, gay, bisexual, and transgender populations. American Journal of Public Health, 92, 1125-1130. - PMC - PubMed
    1. Casey F. E., Sonenstein F. L., Astone N. M., Pleck J. H., Dariotis J. K., Marcell A. V. (2016). Family planning and preconception health among men in their mid-30s: Developing indicators and describing need. American Journal of Men’s Health, 10, 59-67. - PMC - PubMed

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