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Exploring the Pre-exposure Prophylaxis (PrEP) Health Care Experiences Among Men Who Have Sex With Men (MSM) Who Live
Christopher Owens1, Randolph D Hubach2, Deana Williams1
1Center for Sexual Health Promotion, School of Public Health-Bloomington, Indiana University, Bloomington, Indiana.
Abstract:
Most pre-exposure prophylaxis (PrEP) research samples men who have sex with men (MSM) who live in metropolitan cities. There is a limited understanding of the PrEP experiences among rural MSM. Thirty-four semi-structured interviews were conducted to explore the PrEP health care experiences among 34 rural Midwestern MSM. Of the 34 participants, 23 obtained PrEP from their non-primary care provider (PCP). Three themes were present: (1) PrEP is unavailable in rural areas, (2) PrEP is inaccessible in rural areas due to PCPs being unwilling to prescribe PrEP, and (3) PrEP services are unamicable in rural areas due to stigmatizing attitudes and behaviors of PCPs. It is important to address PrEP care continuum factors in all settings; however, these factors are often exacerbated in rural areas due to social determinants. Without further research and programming, organizational and social determinants may contribute to lower rates of PrEP outcomes in rural areas.
Insights
Pre-exposure prophylaxis (PrEP) access is limited for rural men who have sex with men (MSM). Primary care providers
Area of Science:
- Public Health
- Social Science
- Health Disparities Research
Background:
- Pre-exposure prophylaxis (PrEP) research predominantly focuses on men who have sex with men (MSM) in urban settings.
- There is a significant gap in understanding PrEP experiences among MSM residing in rural areas.
- Social determinants of health disproportionately affect rural populations, potentially exacerbating PrEP care continuum challenges.
Purpose of the Study:
- To explore the healthcare experiences of rural Midwestern men who have sex with men (MSM) regarding pre-exposure prophylaxis (PrEP).
- To identify barriers and facilitators to PrEP access and utilization in rural settings.
- To inform targeted interventions and policies to improve PrEP outcomes for rural MSM.
Main Methods:
- Conducted 34 semi-structured interviews with rural Midwestern MSM.
- Explored participants' experiences obtaining and using PrEP.
- Analyzed qualitative data to identify key themes related to PrEP healthcare.
Main Results:
- PrEP services were perceived as unavailable and inaccessible in rural areas.
- Primary care providers (PCPs) were often unwilling to prescribe PrEP.
- Stigmatizing attitudes and behaviors from PCPs created an unamicable environment for PrEP services.
Conclusions:
- Rural settings present unique challenges to PrEP access and utilization due to social and organizational determinants.
- Addressing PCP willingness and combating stigma are crucial for improving PrEP care for rural MSM.
- Further research and targeted programming are necessary to reduce PrEP-related health disparities in rural areas.
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