How Can We PrEP? Exploring Black MSM's Experiences With Pre-Exposure Prophylaxis Through Photovoice

AIDS Educ Prev. 2021 Feb;33(1):16-32. doi: 10.1521/aeap.2021.33.1.16.

Abstract

Pre-exposure prophylaxis (PrEP) can reduce the risk of HIV infection by over 90% among those at high risk via sexual transmission. PrEP acceptance and adherence remains low among those at highest risk of HIV, including Black men who have sex with men (MSM) in the southern U.S. This community-based participatory research project explored Black MSM's experiences with PrEP in North Carolina through photovoice, a methodology using photography and discussion. Our findings highlighted challenges and opportunities with PrEP, including intersectional stigma, the need for improved patient-provider education, and the role of community-based organizations in closing patient-provider gaps. This work is a first step towards understanding the daily lives of Black MSM on PrEP in the Triangle Region of North Carolina, including barriers and facilitators to PrEP use. Implications for public health practice highlight the need for conducting community-level interventions, integrating PrEP into primary care, and normalizing PrEP through community conversations.

Keywords: HIV prevention; Photovoice; health equity; men who have sex with men; pre-exposure prophylaxis; racial equity.

MeSH terms

  • Adult
  • Black or African American / psychology*
  • Community-Based Participatory Research
  • HIV Infections / ethnology
  • HIV Infections / prevention & control*
  • Health Equity
  • Health Services Accessibility
  • Homosexuality, Male / ethnology*
  • Homosexuality, Male / psychology
  • Humans
  • Male
  • North Carolina
  • Patient Acceptance of Health Care
  • Pre-Exposure Prophylaxis / methods*
  • Professional-Patient Relations
  • Qualitative Research
  • Safe Sex
  • Social Stigma*