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. 2018 Apr;22(4):1139-1149.
doi: 10.1007/s10461-017-1964-6.

Sex, PrEP, and Stigma: Experiences with HIV Pre-exposure Prophylaxis Among New York City MSM Participating in the HPTN 067/ADAPT Study

Julie Franks  1 , Yael Hirsch-Moverman  2   3 , Avelino S Loquere Jr  2 , K Rivet Amico  4 , Robert M Grant  5 , Bonnie J Dye  6 , Yan Rivera  2 , Robert Gamboa  2 , Sharon B Mannheimer  2   3   7
Affiliations

Sex, PrEP, and Stigma: Experiences with HIV Pre-exposure Prophylaxis Among New York City MSM Participating in the HPTN 067/ADAPT Study

Julie Franks et al. AIDS Behav. 2018 Apr.

Abstract
in English, Spanish

The HPTN 067/Alternative Dosing to Augment Pre-Exposure Prophylaxis Pill Taking (ADAPT) study evaluated daily and non-daily dosing schedules for oral pre-exposure prophylaxis (PrEP) to prevent HIV. A qualitative sub-study including focus groups and in-depth interviews was conducted among men who have sex with men participating in New York City to understand their experience with PrEP and study dosing schedules. The 37 sub-study participants were 68% black, 11% white, and 8% Asian; 27% were of Hispanic/Latino ethnicity. Mean age was 34 years. Themes resulting from qualitative analysis include: PrEP is a significant advance for HIV prevention; non-daily dosing of PrEP is congruent with HIV risk; and pervasive stigma connected to HIV and risk behavior is a barrier to PrEP adherence, especially for non-daily dosing schedules. The findings underscore how PrEP intersects with other HIV prevention practices and highlight the need to understand and address multidimensional stigma related to PrEP use.

El estudio HPTN 067/Dosificación Alternativa para Aumentar la Toma de Pastillas de la Profilaxis Pre-Exposición (conocido por su sigla en inglés, ADAPT) evaluó tres estrategias, una diaria y dos no diarias, para la dosificación de la profilaxis pre-exposición oral (PrEP) para prevenir el VIH. Se realizó un sub-estudio cualitativo que incluyó grupos focales y entrevistas en profundidad con hombres que tienen sexo con otros hombres participando en el estudio en la Ciudad de Nueva York. El motivo del sub-estudio fue entender como los participantes experimentaron la PrEP y las estrategias de dosificación del estudio. Los 37 participantes del sub-estudio fueron 68% negro, 11% blanco y 8% asiático; 27% fueron de etnia hispana/latina. La edad media fue de 34 años. Los temas que resultaron del análisis cualitativo incluyen: La PrEP es un avance significativo para la prevención del VIH; hay una congruencia entre la dosificación no diaria de PrEP y los patrones del riesgo de VIH; y el penetrante estigma relacionado con el VIH es una barrera a la adherencia a la PrEP, especialmente para las estrategias de dosificación no diarias. Los hallazgos subrayan cómo la PrEP se intersecta con otras prácticas de prevención del VIH y resaltan la necesidad de entender y abordar el estigma multidimensional relacionado con el uso de PrEP.

Keywords: Adherence; MSM; Pre-exposure prophylaxis; Sexual behavior; Stigma.

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Conflict of interest statement

Conflicts of interest

Julie Franks, Yael Hirsch-Moverman, Avelino S. Loquere, Jr., Robert M. Grant, Bonnie J. Dye, Yan Rivera, Robert Gamboa, and Sharon B. Mannheimer declare no conflict of interest. K. Rivet Amico received an unrestricted educational grant to University of Michigan from Gilead Sciences in 2015 and served on a PrEP-focused Medical Advisory Board meeting with Gilead Sciences in 2017.

Ethical Approval

The main HPTN 067/ADAPT study and the sub-study reported on in this manuscript were reviewed and approved by the Columbia University Medical Center Institutional Review Board. All participants provided written, informed consent to participate in the main and sub-studies. All procedures performed in the main HPTN 067/ADAPT study and the sub-study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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