Why not just go on PrEP?”: A study to inform implementation of an HIV prevention intervention among Hispanic/Latino men who have sex with men in the Northeastern United States

Abstract

Background: Pre-exposure prophylaxis (PrEP) is an effective biological option for HIV prevention yet persistent disparities in PrEP uptake and retention exist among Hispanic/Latino men who have sex with men (MSM). We evaluated barriers and facilitators to PrEP care among Hispanic/Latino MSM at risk for and living with HIV. Setting: A small, urban setting in the Northeastern United States. Methods: This was a mixed-methods, exploratory, sequential qualitative and quantitative pilot study among Latino MSM at-risk and/or living with HIV across: 1) semi-structured qualitative interviews (N=15); and 2) cross-sectional survey (N=98). Results: Participants reported a diverse range of sexual identities, HIV statuses, and PrEP statuses. Qualitative participants described feelings of isolation in both Hispanic/Latino and queer communities that made it challenging to learn about HIV prevention or PrEP from peers. Participants in the survey indicated that they would be more inclined to uptake PrEP if PrEP were offered in primary care settings (n=61; 62.2%); there were specific LGBTQ+ affirming medical settings (n=36; 36.7%); and/or they could meet other people who are currently on PrEP and sharing experiences online (n=46; 46.9%) or in person (n=38; 38.8%). Findings were organized to reflect determinants and implementation strategies that could be used to improve PrEP uptake among this population. Conclusion: This mixed-methods study identified several challenges and opportunities for increasing the reach of PrEP to Hispanic/Latino MSM. These findings should be used to inform tailored implementation strategies to promote PrEP uptake among this at-risk yet currently underserved population.