Perceptions of HIV Pre-Exposure Chemoprophylaxis among HIV-Negative, Post-Incarcerated, African American MSM

Abstract

Aims: To explore barriers and facilitators to using and adhering to Truvada, among HIV-negative, post-incarcerated, African American men who have sex with men (MSM). Background: African American MSM represent only 2% of the U.S. population, yet account for 73% of new HIV infections among African American men. Truvada was FDA approved in 2012 for chemoprophylaxis in HIV-negative persons at high HIV risk. According to CDC guidelines, Truvada is most efficacious when used daily in addition to consistent condom use from the beginning to end of sex, and with 2-3 month medical checks and counseling. Methods: In this qualitative ethnographic study we used convenience and snowball sampling. Participants were recruited from Men’s Central Jail in Los Angeles in collaboration with the Center for Health Justice. Data were gathered using semi-structured questions in one and one half hour, audio-recorded, focus group sessions. Analysis: Transcripts were analyzed using AtlasTi qualitative software. Findings: 1. HIV-related stigma continues in African American communities 2. Post-incarcerated HIV-negative African American MSM may not consistently use or adhere to Truvada 3. Use of Truvada may mean that the user is HIV positive or gay, and 4. African American MSM may not use condoms with Truvada. 5. Truvada should be given to men who are incarcerated.