Acceptability of pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) in Benin: a qualitative study

ABSTRACT

In Benin, consistent condom use among men who have sex with men (MSM)  is relatively low and providing them with Pre-exposure prophylaxis (PrEP) could be of great relevance. We aimed to describe PrEP knowledge and intention to use it; identify key facilitators and barriers to PrEP; and describe the perceived impact of PrEP on unsafe sexual behavior. MSM, 18 years or older, HIV-negative or of unknown status, were enrolled in five cities of Benin. Intention to use PrEP was assessed through five focus groups (FG). Data were analyzed using manual thematic sorting. Thirty MSM (six per city) participated in the FG. Mean age (standard deviation) was 27.1 (5.0) years. All participants expressed the intention to use PrEP if made available. Facilitators of PrEP use were: availability of medication, safety, absence of constraints as well as freedom to have multiple sex partners and sex with HIV-positive friends. Barriers were: complex procedures for obtaining medication, size and taste of medication, cost of medication, poor PrEP awareness.. Eighteen men admitted that PrEP could lead to decrease in or even abandonment of condom use. In conclusion, MSM showed openness to use PrEP if available, although they recognized that it could lead to risk compensation.

KEYWORDS:

• Acceptability
• feasibility
• PrEP
• HIV
• MSM
• Benin

Acknowledgements

All authors have actively contributed to the design and execution of the study. MA secured the funding. CA led the data collection and wrote the first draft of this article. All co-authors read and commented the manuscript, and approved its content. The authors wish to thank the participants, especially the representatives of their respective associations.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by Canadian Institutes of Health Research [grant number FDN-143218].