Barriers and facilitators to PrEP use and HIV testing for subgroups of Latino sexual minority men

ABSTRACT

Pre-exposure prophylaxis (PrEP) and HIV testing inadequately reach Latino sexual minority men (LSMM), fueling HIV disparities. This study identified determinants of LSMM’s PrEP use and HIV testing and examined differences across subgroups (i.e., age and immigration history). First, we identified the most to least endorsed barriers and facilitators of PrEP use and HIV testing among LSMM (1) over vs. under 40 years old, and (2) across immigration histories (U.S. born, recent immigrant, established immigrant). Next, we examined differences in barrier/facilitator ratings across these age and immigration status groups. Key overall determinants were cost, knowledge, and perceived benefit/need. However, there was variation in determinants across age groups (i.e., cost, affordability, navigation support, and normalization) and immigration statuses (i.e., language, immigration concerns, and HIV knowledge). There were also differences across service types; mistrust and concerns was a barrier related to PrEP but not HIV testing. We found unique and common multilevel factors across prevention services and subgroups. Language, cost, and clinic/system issues are key barriers in accessing HIV prevention that should be considered when developing implementation strategies to enhance the reach of these services to LSMM.

KEYWORDS:

• Latino
• HIV
• PrEP
• age
• immigration status

Disclosure statement

Dr. Safren receives royalties for books published by Guilford Press, Oxford University Press, and Springer/Humana Press. No potential conflict of interest was reported by the authors.

Data availability statement

The data that support the findings of this study are available from the corresponding author, A.H., upon reasonable request with an approved concept sheet and data use agreement.

Notes

1 We use the term “sexual minority men” (SMM) when referring to participants in the current study as well as other studies in which all participants identified as gay, bisexual, or another sexual minority identity. We use the term “men who have sex with men” (MSM), a behavioral term, when describing men who may or may not identify as sexual minority men, but report having sex with men.

Additional information

Funding

This work was supported by the Center for AIDS Research (CFAR) at the University of Miami under Grant P30AI07396; the National Institute on Minority Health and Health Disparities under Grants U54MD002266 and K23MD015690; and the National Institute of Mental Health under Grant P30MH116867. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.