Marie Bistoquet1, Alain Makinson1,2, Vincent Tribout3, Cyril Perrollaz3, Gérard Bourrel4,5, Jacques Reynes1,2,3, Agnès Oude Engberink6,7,8. 1. Département Des Maladies Infectieuses, Centre Hospitalier Universitaire, Montpellier, France. 2. UMI 233/INSERM U1175, Université de Montpellier, Montpellier, France. 3. Centre Gratuit, D'information, de Dépistage Et de Diagnostic Des Infections Sexuellement Transmissible, Centre Hospitalier Universitaire, Montpellier, France. 4. Département Universitaire de Médecine Générale, Université de Montpellier, Montpellier, France. 5. Institut Desbret D'Épidémiologie Et de Santé Publique, Université de Montpellier, Montpellier, France. 6. Département Universitaire de Médecine Générale, Université de Montpellier, Montpellier, France. agnes.oude-engberink@umontpellier.fr. 7. Institut Desbret D'Épidémiologie Et de Santé Publique, Université de Montpellier, Montpellier, France. agnes.oude-engberink@umontpellier.fr. 8. Maison de Santé Pluriprofessionnelle Universitaire Avicenne, 2 rue IBN Sinaï Dit Avicenne, 66330, Cabestany, France. agnes.oude-engberink@umontpellier.fr.
Abstract
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.
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.
Entities:
Keywords:
HIV prevention; Phenomenology; Pre-exposure prophylaxis; Qualitative research; Quality of life
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