Multifaceted Barriers to Rapid Roll-out of HIV Pre-exposure Prophylaxis in China: A Qualitative Study Among Men Who Have Sex with Men.

Content Provider	Europe PMC
Author	Li, Chunyan Xiong, Yuan Liu, Honglin Luo, Danyang Tucker, Joseph D. Maman, Suzanne Matthews, Derrick D. Fisher, Edwin B. Tang, Weiming Muessig, Kathryn E.
Abstract	BackgroundOral pre-exposure prophylaxis (PrEP) as a safe and effective antiretroviral medicine-based prevention against HIV has not been widely adopted by gay, bisexual, and other men who have sex with men (MSM) in China. A deeper understanding of barriers and facilitators to PrEP uptake is needed to inform the development of effective interventions.MethodDuring July–August 2020, we conducted one-on-one semi-structured interviews with 31 Chinese MSM with varied PrEP use experiences (PrEP-naïve, former, and current PrEP users). Interviews were digitally recorded and transcribed in Chinese. Informed by the Information-Motivation-Behavioral Skills Model (IMB), we analyzed the data using a thematic analysis approach to identify the barriers and facilitators to PrEP uptake among Chinese MSM.ResultsMajor barriers to PrEP uptake among MSM in the sample included uncertainty about PrEP efficacy and lack of PrEP education (information), concerns over potential side effects and cost (motivation), and difficulties in identifying authentic PrEP medications and managing PrEP care (behavioral skills). Facilitators include the perceived benefit of PrEP in improving the quality of sex life and control over health. At the contextual level, we also identified barriers to PrEP access from a thriving informal PrEP market and stressors related to being MSM.ConclusionOur findings identified a need to invest in non-discriminatory public health messaging of PrEP, explore options for MSM-friendly provision of PrEP outside of traditional HIV care settings, and be attentive to the unique context of an established informal PrEP market in future PrEP initiatives.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12529-023-10177-y.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC10166630&blobtype=pdf
ISSN	10705503
Journal	International Journal of Behavioral Medicine [Int J Behav Med]
DOI	10.1007/s12529-023-10177-y
PubMed Central reference number	PMC10166630
PubMed reference number	37156941
e-ISSN	15327558
Language	English
Publisher	Springer US
Publisher Date	2023-05-08
Publisher Place	New York
Access Restriction	Open
Rights License	This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. © International Society of Behavioral Medicine 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
Subject Keyword	HIV Pre-exposure prophylaxis Men who have sex with men China
Content Type	Text
Resource Type	Article
Subject	Applied Psychology