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. 2022 May;26(5):1572-1586.
doi: 10.1007/s10461-021-03510-7. Epub 2021 Oct 27.

Barriers to Pre-Exposure Prophylaxis Uptake Among Online Male Sex Workers in the US

Anne E Sundelson  1 , Étienne Meunier  2 , Eric W Schrimshaw  3 , Karolynn Siegel  2
Affiliations

Barriers to Pre-Exposure Prophylaxis Uptake Among Online Male Sex Workers in the US

Anne E Sundelson et al. AIDS Behav. 2022 May.

Abstract

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.

Keywords: HIV; Male sex workers; Men who have sex with men; Pre-exposure prophylaxis.

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Conflict of interest statement

Conflicts of interest/competing interests

The authors have no relevant financial or non-financial interests to disclose.

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