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Perceptions of Sexual Risk, PrEP Services, and Peer Navigation Support Among HIV-Negative Latinx and Black Men who have Sex with Men (MSM) Residing in Western Washington

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Abstract

Introduction

HIV PrEP (pre-exposure prophylaxis) is underutilized among Latinx and Black men who have sex with men (MSM) in the USA. Although peer navigation approaches may increase PrEP uptake and adherence, it remains unclear what strategies work best for MSM of color.

Methods

From July 2017 to August 2018, we conducted semi-structured in-depth interviews with 25 purposively sampled Latinx and Black cisgender MSM to evaluate how the intersectionality of race/ethnicity, sexual orientation, and other identities influenced men’s views on PrEP in general and on peer navigation specifically. Thematic analysis was used to identify and analyze emergent themes.

Results

Emergent themes included (1) awareness of vulnerability in intimate relationships; (2) barriers to PrEP initiation including perceived side effects, stigma, and financial concerns; (3) a wish to connect with other Latinx and Black MSM in a health and prevention space; and (4) the desire for peer matching based on identity considerations and lived experience. Younger men and Spanish-speaking Latinx men were most interested in peer navigation to access PrEP, while bisexual men had confidentiality concerns.

Conclusions

In our study, Latinx and Black MSM viewed peer navigation services favorably, especially if they addressed men’s desire to connect with other MSM of color.

Policy Implications

Developing culturally congruent peer navigation programming could help improve PrEP uptake and care engagement for Latinx and Black MSM. Programs should recruit peers from the racial/ethnic minority communities most impacted by HIV and prioritize matching peers to clients based on identity concerns, needs, and preferences.

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Acknowledgements

The authors would like to thank the men who participated in the What’s PrEP? and ¿Qué es PrEP? interviews for their time and their willingness to share intimate aspects of their lives. We are especially grateful to our community partners, who helped us recruit participants and invited us into their spaces to learn about the Latinx and Black communities in western Washington. We would like to especially acknowledge Lesster Munguía and Joel Aguirre at Entre Hermanos and Tristan Gardner, formerly at the Center for MultiCultural Health.

Funding

This research was funded by a 2016 Global to Local developmental grant from the University of Washington/Fred Hutch Center for AIDS Research, an NIH funded program under award number AI027757 which is supported by the following NIH Institutes and Centers: NIAID, NCI, NIMH, NIDA, NICHD, NHLBI, NIA, NIGMS, NIDDK. SMG was also supported by the Robert W. Anderson Professorship in Medicine. JDS was supported by Washington State Department of Health.

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Authors and Affiliations

Authors

Contributions

SMG designed the study. VG, LFR, LC, KW, and JJ helped with recruitment of participants. JJ and JH conducted all interviews. JJ, SMG, KW, and LBS analyzed the data, with input on coding and cultural context from LBS and RDC. JJ drafted the initial manuscript, and MA, JS, and SMG provided critical input. All the authors read the manuscript, provided critical review, and approved the final version.

Corresponding author

Correspondence to Jahn Jaramillo.

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Ethical Approval

Approval was obtained from the University of Washington institutional review board (STUDY00000239).

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

The authors declare no competing interests.

Disclaimer

The funding bodies had no role in study design, data collection and interpretation, or analysis of the data.

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Jaramillo, J., Pagkas-Bather, J., Waters, K. et al. Perceptions of Sexual Risk, PrEP Services, and Peer Navigation Support Among HIV-Negative Latinx and Black Men who have Sex with Men (MSM) Residing in Western Washington. Sex Res Soc Policy 19, 1058–1068 (2022). https://doi.org/10.1007/s13178-021-00595-6

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  • DOI: https://doi.org/10.1007/s13178-021-00595-6

Keywords

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