Biomedical HIV Prevention among Gay Male Couples: A Qualitative Study of Motivations and Concerns

ABSTRACT

Pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) are highly efficacious biomedical prevention strategies, which significantly reduce the risk of HIV transmission. Yet, partnered sexual minority men (SMM) continue to exhibit poorer uptake rates especially those in a non-monogamous or serodiscordant relationship for whom PrEP is recommended. The purpose of the study was to identify factors that may facilitate or impede the uptake of PrEP or PEP among partnered SMM. This qualitative study conducted semi-structured interviews with 10 sexual minority male couples recruited from the New York City metropolitan area. Thematic analysis identified relationship-specific and structural-level factors, which influence motivation and willingness for biomedical prevention uptake. Specifically, results highlighted the tension between relationship functioning and HIV prevention. In addition, stigma and access to knowledgeable health care providers diminished interest in biomedical prevention. Findings suggest a need for interventions that frame biomedical prevention in ways that minimize social perceptions of mistrust between partners and improve access.

KEYWORDS:

• Same-sex couples
• sexual minority men
• pre-exposure prophylaxis (PrEP)
• post-exposure prophylaxis (PEP)
• HIV prevention
• biomedical prevention

Acknowledgments

The authors acknowledge the contributions of the Couples Health Project team, particularly Andrew Cortopassi, Nahuel Smith, Ruben Jimenez, and Scott Jones. We also thank Cheryl Carmichael for her support in the completion of this paper; William Aklin for his support of the project; as well as our participants who volunteered their time.

Additional information

Funding

This study was supported by a grant from The National Institute of Drug Abuse (R34 DA043422 & R34 DA036419; PI Starks).