Pre-exposure prophylaxis makes it possible to better live one's sexuality and guide men who have sex with men towards a responsible approach to their health: a phenomenological qualitative study about primary motivations for PrEP.


Journal

AIDS research and therapy
ISSN: 1742-6405
Titre abrégé: AIDS Res Ther
Pays: England
ID NLM: 101237921

Informations de publication

Date de publication:
07 01 2021
Historique:
received: 14 07 2020
accepted: 14 12 2020
entrez: 8 1 2021
pubmed: 9 1 2021
medline: 31 8 2021
Statut: epublish

Résumé

Pre-exposure prophylaxis (PrEP) for HIV is instrumental in the prevention of HIV for HIV-uninfected persons, by drastically reducing the risk of acquisition in the case of high-risk exposures. Despite its demonstrated efficacy, it remained under-prescribed in France until 2018. The principal aim of this study was to understand the motivations of Men who have Sex with Men (MSM) who started using PrEP in Montpellier, France. A phenomenological study was undertaken, using semi-structured interviews with twelve participants attending the University Hospital of Montpellier for PrEP. Interviews were analysed by means of triangulation up to the point of theoretical saturation, using a semio-pragmatic method. Fear of HIV infection, personalised regular follow-up, and the wish to take care of one's health were the primary motivational factors. PrEP allows for a better sexual life restoring a sense of freedom despite the risks of STI, deemed manageable by PrEPers. PrEP does not modify long-term risk-taking behaviours but helps them better live their own sexuality and guides them towards a responsible approach to sexuality. Unclear information on PrEP, delivered by their family doctor, public campaigns or the media, leads to misrepresentations or negative social representation, including within the MSM community, which may delay its implementation. Fear of HIV infection and the benefits of regular medical follow-up to take care of one's health were motivational factors of importance for the use of PrEP by MSM in this study. PrEP transforms all existential dimensions of their lived experience, improving sexual identity and happiness. There is a need to improve professional awareness of the effectiveness of PrEP and to develop a patient centered approach, to disseminate information more widely to the general public and among MSM to reduce stigmatisation.

Sections du résumé

BACKGROUND
Pre-exposure prophylaxis (PrEP) for HIV is instrumental in the prevention of HIV for HIV-uninfected persons, by drastically reducing the risk of acquisition in the case of high-risk exposures. Despite its demonstrated efficacy, it remained under-prescribed in France until 2018. The principal aim of this study was to understand the motivations of Men who have Sex with Men (MSM) who started using PrEP in Montpellier, France.
METHODS
A phenomenological study was undertaken, using semi-structured interviews with twelve participants attending the University Hospital of Montpellier for PrEP. Interviews were analysed by means of triangulation up to the point of theoretical saturation, using a semio-pragmatic method.
RESULTS
Fear of HIV infection, personalised regular follow-up, and the wish to take care of one's health were the primary motivational factors. PrEP allows for a better sexual life restoring a sense of freedom despite the risks of STI, deemed manageable by PrEPers. PrEP does not modify long-term risk-taking behaviours but helps them better live their own sexuality and guides them towards a responsible approach to sexuality. Unclear information on PrEP, delivered by their family doctor, public campaigns or the media, leads to misrepresentations or negative social representation, including within the MSM community, which may delay its implementation.
CONCLUSIONS
Fear of HIV infection and the benefits of regular medical follow-up to take care of one's health were motivational factors of importance for the use of PrEP by MSM in this study. PrEP transforms all existential dimensions of their lived experience, improving sexual identity and happiness. There is a need to improve professional awareness of the effectiveness of PrEP and to develop a patient centered approach, to disseminate information more widely to the general public and among MSM to reduce stigmatisation.

Identifiants

pubmed: 33413434
doi: 10.1186/s12981-020-00327-7
pii: 10.1186/s12981-020-00327-7
pmc: PMC7791866
doi:

Substances chimiques

Anti-HIV Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2

Références

BMJ. 2017 Dec 11;359:j5011
pubmed: 29229609
N Engl J Med. 2010 Dec 30;363(27):2587-99
pubmed: 21091279
AIDS Behav. 2014 Sep;18(9):1712-21
pubmed: 24965676
AIDS Patient Care STDS. 2013 Oct;27(10):560-6
pubmed: 24093809
AIDS Patient Care STDS. 2013 Apr;27(4):248-54
pubmed: 23565928
BMC Palliat Care. 2020 Mar 20;19(1):34
pubmed: 32197609
Int J Qual Health Care. 2007 Dec;19(6):349-57
pubmed: 17872937
Crisis. 1997;18(1):24-34
pubmed: 9141776
AIDS Behav. 2017 May;21(5):1325-1335
pubmed: 27900502
PLoS One. 2014 Aug 18;9(8):e105283
pubmed: 25133648
Drugs. 2019 Apr;79(6):609-619
pubmed: 30963509
J Acquir Immune Defic Syndr. 2016 Jul 1;72(3):e80-1
pubmed: 27035886
Lancet HIV. 2019 Jul;6(7):e447-e455
pubmed: 31178284
AIDS Educ Prev. 2019 Apr;31(2):152-162
pubmed: 30917012
AIDS Behav. 2019 Dec;23(12):3375-3383
pubmed: 31102107
Can J Public Health. 2019 Feb;110(1):72-75
pubmed: 30341481
J Int AIDS Soc. 2019 Oct;22(10):e25389
pubmed: 31612621
Ann Behav Med. 2015 Apr;49(2):177-86
pubmed: 25124457
BMC Public Health. 2019 Sep 6;19(1):1236
pubmed: 31492120
J Am Assoc Nurse Pract. 2016 Aug;28(8):446-52
pubmed: 26814031
J Int AIDS Soc. 2019 Feb;22(2):e25252
pubmed: 30775846
AIDS Care. 2016;28 Suppl 1:48-55
pubmed: 26883400
AIDS Res Ther. 2012 Aug 01;9(1):23
pubmed: 22853692
AIDS Res Ther. 2016 Jan 19;13:5
pubmed: 26793265
Lancet. 2016 Jan 2;387(10013):53-60
pubmed: 26364263
AIDS Res Ther. 2018 Oct 19;15(1):14
pubmed: 30340607
AIDS Patient Care STDS. 2016 Jun;30(6):282-90
pubmed: 27220036
N Engl J Med. 2015 Dec 3;373(23):2237-46
pubmed: 26624850

Auteurs

Marie Bistoquet (M)

Département Des Maladies Infectieuses, Centre Hospitalier Universitaire, Montpellier, France.

Alain Makinson (A)

Département Des Maladies Infectieuses, Centre Hospitalier Universitaire, Montpellier, France.
UMI 233/INSERM U1175, Université de Montpellier, Montpellier, France.

Vincent Tribout (V)

Centre Gratuit, D'information, de Dépistage Et de Diagnostic Des Infections Sexuellement Transmissible, Centre Hospitalier Universitaire, Montpellier, France.

Cyril Perrollaz (C)

Centre Gratuit, D'information, de Dépistage Et de Diagnostic Des Infections Sexuellement Transmissible, Centre Hospitalier Universitaire, Montpellier, France.

Gérard Bourrel (G)

Département Universitaire de Médecine Générale, Université de Montpellier, Montpellier, France.
Institut Desbret D'Épidémiologie Et de Santé Publique, Université de Montpellier, Montpellier, France.

Jacques Reynes (J)

Département Des Maladies Infectieuses, Centre Hospitalier Universitaire, Montpellier, France.
UMI 233/INSERM U1175, Université de Montpellier, Montpellier, France.
Centre Gratuit, D'information, de Dépistage Et de Diagnostic Des Infections Sexuellement Transmissible, Centre Hospitalier Universitaire, Montpellier, France.

Agnès Oude Engberink (A)

Département Universitaire de Médecine Générale, Université de Montpellier, Montpellier, France. agnes.oude-engberink@umontpellier.fr.
Institut Desbret D'Épidémiologie Et de Santé Publique, Université de Montpellier, Montpellier, France. agnes.oude-engberink@umontpellier.fr.
Maison de Santé Pluriprofessionnelle Universitaire Avicenne, 2 rue IBN Sinaï Dit Avicenne, 66330, Cabestany, France. agnes.oude-engberink@umontpellier.fr.

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Classifications MeSH