A small group of early adopters of Truvada (tenofovir disoproxil fumarate/emtricitabine) as pre-exposure prophylaxis (PrEP) reported that starting the HIV prevention method had a profound effect on their sexual health and well-being, aidsmap reports. However, some also reported being stigmatized for taking PrEP.
According to the World Health Organization, the term “sexual health” refers broadly to “a state of physical, mental and social well-being in relation to sexuality.”
Publishing their findings in the International Journal of Sexual Health, researchers conducted in-depth interviews with 14 men who have sex with men (MSM) using PrEP in Seattle. The majority of the men were white (Seattle is about 70 percent white); there was one Black participant and one Latino participant. One of the participants was a trans man who has sex with men. The men ranged in age between 26 and 66; most were in their 30s or 40s.
The men had not been using PrEP for long, with half only on Truvada for three months or less at the time of the interview; just two had been on PrEP for a year or longer.
The predominant motivating factor behind the men’s uptake of PrEP was a desire to mitigate risk when having sex without a condom. The majority of them already had a history of inconsistent condom use, or lack of condom use, before starting Truvada. They had acknowledged that these sexual behavior patterns were entrenched and unlikely to change, but they wished to avoid contracting HIV, making PrEP a logical fit.
The men had wrestled with conflicted feelings over their sexual risk taking prior to starting PrEP and often felt fatalistic about contracting HIV. Using PrEP helped reduce feelings of vulnerability, anxiety, fear and shame that the men associated with their sexual behavioral patterns. Truvada also afforded them new opportunities to have more satisfying sex, to experience intimacy and gain a greater sense of self-efficacy and empowerment.
After starting PrEP, the study participants felt more open to and less anxious about partnerships and sex with HIV-positive men.
On the downside, the men expressed concerns about being stigmatized for taking PrEP and labeled as irresponsible and promiscuous; sometimes health care providers contributed to such stigma. Some of the men seemed to internalize PrEP-related stigma, experiencing related internal conflict, shame and regret.
To read the aidsmap article, click here.
To read the study abstract, click here.