‘Get up, brush teeth, take PrEP’: a qualitative study of the experiences of London-based MSM using PrEP

Sean Harrington, Dr Matthew Grundy-Bowers, Dr Eamonn McKeown
School of Health Sciences, City, University of London, UK

Pre-exposure prophylaxis (PrEP) is highly effective in preventing transmission of HIV among at-risk groups. A qualitative study with 13 PrEP-using men who have sex with men (MSM) recruited from London, UK, utilised semi-structured interviews to understand knowledge of PrEP, experiences of using PrEP and potential barriers and facilitators to its use. Thematic analysis of transcripts identified six themes: (1) PrEP and condom use; (2) lessened anxiety around HIV; (3) increased intimacy and pleasure; (4) sense of sexual liberation; (5) ease of using PrEP; and (6) activism as an ‘early adopter’ in current UK context. Findings indicate a PrEP-mediated shift in how ‘risk’ and ‘protection’ are conceived. While experiences demonstrate an overall positive affect of using PrEP, the potential impact of decreased condom use on STI rates requires consideration. Ensuring PrEP is embedded in sexual health services that provide adequate surveillance, testing and treatment for other infections may be a way to mitigate the change in behaviour and outweigh the potential risks other infections.

Keywords: PrEP, MSM, HIV prevention, motivations, risk.