'I make sure my doctor doesn't know that I use meth': perceived barriers to pre-exposure prophylaxis (PrEP) uptake among community peer educators in Seattle (WA, USA).

Sex Health

Department of Medicine, University of Washington, 325 9th Avenue, Seattle, WA, 98104, USA; and Department of Global Health, University of Washington, 1510 San Juan Road, Seattle, WA, 98195 USA; and Department of Epidemiology, University of Washington, 1959 NE Pacific Street Seattle, WA, 98195 USA.

Published: February 2020

Unlabelled: Background HIV disproportionately affects cisgender men and transgender people who have sex with men (MSM/TG) and use methamphetamine. Pre-exposure prophylaxis (PrEP) uptake has been slow in this group. It is important to understand perceptions about PrEP and barriers to its use among MSM/TG who use methamphetamine to reduce new HIV infections.

Methods: We conducted four focus groups with peer educators of a harm reduction program. We assessed their perspectives of PrEP and barriers across the PrEP continuum among MSM/TG who use methamphetamine.

Results: Notably, stigma related to the multiple marginalised identities of MSM/TG who use methamphetamine (e.g. MSM/TG-related stigma, methamphetamine-related stigma) was a barrier at each step. We developed a framework that combined the PrEP continuum and a stigma-based treatment cascade to explore these themes and describe the effects of stigma on PrEP engagement. Methamphetamine-related barriers were also identified.

Conclusions: The findings of this study emphasise the importance of incorporating stigma reduction into PrEP delivery for MSM/TG who use methamphetamine.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9677806PMC
http://dx.doi.org/10.1071/SH19083DOI Listing

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