LONDON — Gay and bisexual men have differing attitudes toward men who are using pre-exposure prophylaxis (PrEP), according to U.S. research published in Sociology of Health & Illness. A series of focus groups conducted in New York City showed that some men regarded PrEP users as immoral, irresponsible, naïve and vectors of disease, AIDSmap reports.
In contrast, other men saw PrEP as a beneficial new option for preventing the spread of HIV. They had a nuanced view about the effectiveness of condom-based prevention campaigns and the epidemiology of sexually transmitted infections (STIs) among gay and bisexual men.
Investigators from the City University of New York wanted to make sense of the moral debates surrounding PrEP among gay and bisexual men, especially the extent to which PrEP has been constructed as a “social problem.” They designed a study based on five focus groups, in which 32 gay and bisexual men were invited to share their views about PrEP, in late 2015 and early 2016. PrEP was not mentioned in recruitment advertising as the investigators wished to avoid only attracting men with very strong opinions about it. The focus groups lasted approximately 45 minutes each, AIDSmap reports.
Participants had an average age of 35 years. Most self-identified as gay and 11 were HIV positive. Overall, the men had a good awareness of PrEP. Many reported seeing ads, discussion of PrEP on social media or said they had heard of PrEP from friends, AIDSmap reports.
However, not all the participants discussed PrEP accurately. One participant believed that it was a lifetime commitment, while another believed that if you stopped taking PrEP and subsequently became infected with HIV the virus would be resistant to anti-retrovirals because of previous exposure to medication.
Some of the men construed PrEP as a social problem: its users were seen as promiscuous, irresponsible, immoral and naïve. By and large, these individuals believed that uptake of PrEP was undermining use of condoms and that PrEP users were responsible for ongoing epidemics of STIs among gay and bisexual men, AIDSmap reports.
There were also clear notions of “deserving” and “undeserving” PrEP users. Men in relationships with an HIV-positive partner fell into the former category, AIDSmap reports. In contrast, concern was expressed about the use of PrEP by younger gay and bisexual men. Some participants believed that younger men seeking PrEP should “be educated thoroughly,” that there “should be mental health screening” and that “it has to be made harder to get the pill.”