“Sex without fear”: exploring the psychosocial impact of oral HIV pre-exposure prophylaxis on gay men in England
Year: 2023
Type: article
Abstract: Gay, bisexual, and other men who have sex with men (GBMSM) experience a high prevalence of psychosocial health problems, such as harmful substance use and depression, as well as being disproportionately affected by HIV. HIV Pre-Exposure Prophylaxis (PrEP) may provide psychosocial benefits beyond its intended purpose of reducing HIV infection. We explore the psychosocial impact of oral PrEP use on gay men in England using qualitative data from the PROUD study. From February 2014 to January 2016, semi-structured in-depth interviews were conducted with 40 gay men and one trans woman. Participants were purposively recruited based on trial arm allocation, adherence, and sexual risk behaviours. By removing HIV risk from sex, PrEP improves users' wellbeing by reducing HIV-related anxiety and internalised stigma and increasing HIV prevention self-efficacy, sexual pleasure, and intimacy. In turn, these psychological changes may influence behaviour in the form of greater sexual freedom, reduced harmful drug use, and more protective sexual health behaviours. However, PrEP may create internal conflict for some gay men, due to its disruption of social norms around condom use and its perceived influence on their sexual behaviour leading to reduced condom self-efficacy. These findings provide a baseline of PrEP's psychosocial impact amongst some of the first PrEP users in England and supports calls to consider the psychosocial impact of PrEP in prescribing guidelines.
Source: AIDS Research and Therapy
Institutions: Queen Mary University of London, Chelsea and Westminster Hospital NHS Foundation Trust, Mortimer Market Centre, University College London, Barts Health NHS Trust, Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, UK Health Security Agency, London School of Hygiene & Tropical Medicine, Faculty of Public Health, University of Sheffield, UCL School of Pharmacy, MRC Clinical Trials Unit at UCL, Medical Research Council
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,790
Funders: Gilead Sciences, Central Manchester University Hospitals NHS Foundation Trust, London School of Hygiene and Tropical Medicine, King's College Hospital NHS Foundation Trust, Heart of England NHS Foundation Trust, Imperial College London, Imperial College Healthcare NHS Trust, King's College London, University College London, University of Sussex, University of Glasgow, Public Health England, Sheffield Teaching Hospitals NHS Foundation Trust, Barts Health NHS Trust, Svenska Sällskapet för Antropologi och Geografi, Medical Research Council
Awards: G553738029, Blood borne viruses
OpenAlex ID: W4388654576