‘Why are PrEP gays always like this … ’: psychosocial influences on U.K.-based men who have sex with men’s perceptions and use of HIV pre-exposure prophylaxis

Background
Pre-Exposure Prophylaxis (PrEP) is a prescription-based drug used to prevent the spread of Human Immunodeficiency Virus (HIV). In the four nations of the United Kingdom, those with increased need for HIV prevention (e.g. some groups of men who have sex with men) are eligible for PrEP for free, provided by the National Health Service. However, the uptake of PrEP has faced several challenges and many still report barriers to accessing PrEP. This current study aimed to augment current understandings of key psychosocial factors that encourage and inhibit PrEP usage.

Method
Twenty-two individuals participated in a qualitative interview study and thematic analysis was used to analyse the data.

Results
The findings are presented under three themes: (1) Reckoning with the Legacies of HIV; (2) PrEP versus Condoms: tensions of sexual liberation!; and (3) The Transposition of PrEP Stigma.

Conclusion
This study highlights current psychosocial barriers to PrEP uptake and use, as well as the benefits (e.g. reduced HIV anxiety) that PrEP usage can elicit. Three superordinate themes describe how PrEP use is influenced by perceptions of HIV and individuals’ condom use preferences. These coalesce into an identity of a ‘PrEP User’, shaping how stigmas associated with PrEP are then both attributed and mitigated. These data hold merit for informing future PrEP uptake campaigns.