The Impact of Pre-Exposure Prophylaxis (PrEP) Use on Sexual Anxiety, Satisfaction, and Esteem Among Gay and Bisexual Men

Abstract

Gay and bisexual men (GBM) with heightened fears of human immunodeficiency virus (HIV) acquisition have reported high levels of sexual anxiety and low sexual self-esteem. Similarly, sexual satisfaction has been reported to be lower among some GBM who rely solely on condom use as HIV prevention. We sought to explore whether pre-exposure prophylaxis (PrEP) had an impact on the sexual satisfaction, anxiety, and esteem of GBM. As part of a longitudinal cohort study of 1,071 GBM, participants reported at three time points on PrEP use and completed the Multidimensional Sexual Self-Concept Questionnaire (MSSCQ). A total of 137 GBM began taking PrEP in the 24 months following baseline. Comparing their responses during times before initiating PrEP and after, within adjusted multilevel models, there was a significant decrease in sexual anxiety (B = −0.27, p = 0.03) but no significant changes in sexual esteem or satisfaction. Our findings indicate important psychological improvements resulting from PrEP initiation. Further research should explore the potential for other psychological benefits of PrEP use among GBM.

Acknowledgments

The authors would like to acknowledge the contributions of the other members of the One Thousand Strong Study Team (Ana Ventuneac, Demetria Cain, Mark Pawson, Ruben Jimenez, Chloe Mirzayi, Brett Millar, and Raymond Moody) and other staff from the Center for HIV/AIDS Educational Studies and Training (Chris Hietikko, Brian Salfas, Carlos Ponton, and Paula Bertone). We would also like to thank the staff at Community Marketing, Inc. (David Paisley, Heather Torch, and Thomas Roth). Finally, we thank Jeffrey Schulden at the National Institute on Drug Abuse, the anonymous reviewers of this manuscript, and all of our participants in the One Thousand Strong study.

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Funding

The One Thousand Strong study was funded by a research grant from the National Institute on Drug Abuse (R01-DA036466; Jeffrey T. Parsons and Christian Grov, MPIs). H. Jonathon Rendina was supported by a Career Development Award from the National Institute on Drug Abuse (K01-DA039030; H. Jonathon Rendina, PI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.