Social, structural, behavioral and clinical factors influencing retention in Pre-Exposure Prophylaxis (PrEP) care in Mississippi

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  • Arnold, Trisha
    • Other Affiliation: Jackson State University
  • Brinkley-Rubinstein, Lauren
    • Affiliation: School of Medicine, Department of Social Medicine
    • Other Affiliation: UNC Center for Health Equity Research
  • Chan, Philip A.
    • Other Affiliation: Warren Alpert Medical School; Brown University
  • Perez-Brumer, Amaya
    • Other Affiliation: Department of Sociomedical Sciences; Columbia University
  • Bologna, Estefany S.
    • Other Affiliation: Jackson State University
  • Beauchamps, Laura
    • Other Affiliation: Department of Medicine; University of Mississippi Medical Center
  • Johnson, Kendra
    • Other Affiliation: Mississippi State Department of Health
  • Mena, Leandro
    • Other Affiliation: Department of Medicine; University of Mississippi Medical Center
  • Nunn, Amy
    • Other Affiliation: Warren Alpert Medical School; Brown University
Abstract
  • Pre-exposure prophylaxis (PrEP) is a biomedical intervention that can reduce rates of HIV transmission when taken once daily by HIV-negative individuals. Little is understood about PrEP uptake and retention in care among the populations most heavily impacted by the HIV epidemic, particularly among young men who have sex with men (YMSM) in the Deep South. Therefore, this study explored the structural, social, behavioral, and clinical factors that affect PrEP use and retention in care among YMSM in Jackson, Mississippi. Thirty MSM who were prescribed PrEP at an outpatient primary care clinic were interviewed and included 23 men who had been retained in PrEP care and seven who had not been retained. The mean age of participants was 26.6 years. Most (23) participants were African American. Major factors affecting PrEP use and retention in PrEP care included 1) structural factors such as cost and access to financial assistance for medications and clinical services; 2) social factors such as stigma and relationship status; 3) behavioral factors including sexual risk behaviors; and 4) clinical factors such as perceived and actual side effects. Many participants also discussed the positive spillover effects of PrEP use and reported that PrEP had a positive impact on their health. Four of the seven individuals who had not been retained re-enrolled in PrEP care after completing their interviews, suggesting that case management and ongoing outreach can enhance retention in PrEP care. Interventions to enhance retention in PrEP care among MSM in the Deep South will be most effective if they address the complex structural, social, clinical, and behavioral factors that influence PrEP uptake and retention in PrEP care.
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  • Article
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  • In Copyright
Journal title
  • PloS One
Journal volume
  • 12
Journal issue
  • 2
Page start
  • e0172354
Language
  • English
ISSN
  • 1932-6203

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