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What does PrEP mean for 'safe sex' norms? A qualitative study
Bridget Haire1, Dean Murphy1, Lisa Maher1
1Kirby Institute, UNSW Sydney, Kensington, New South Wales, Australia.
Plos One
|August 5, 2021
Summary
Pre-exposure prophylaxis (PrEP) has changed safe sex practices for gay men, reducing condom use and shifting stigma. Health promotion should offer choices in HIV prevention, not enforce rigid standards.
Area of Science:
- Public Health
- Sociology
- Sexual Health
Background:
- HIV pre-exposure prophylaxis (PrEP) is highly effective but has altered traditional safe sex norms centered on condom use.
- The adoption of PrEP has prompted a re-evaluation of sexual negotiation and risk reduction strategies within communities.
- Understanding the cultural impact of PrEP is crucial for effective public health interventions.
Purpose of the Study:
- To explore the culture of PrEP adoption among gay men in Sydney, Australia.
- To examine evolving concepts of 'safe sex' in the context of increasing PrEP accessibility.
- To identify community engagement and stigma associated with PrEP use.
Main Methods:
- Qualitative study design.
- Thematic analysis of data from interviews with sexually active gay men (n=31).
- Interviews and focus groups with key stakeholders (n=10).
Main Results:
- Condom use has decreased in centrality for risk reduction among participants.
- New patterns of sexual negotiation have emerged with PrEP adoption.
- Stigma associated with not taking PrEP was observed to be greater than stigma related to taking PrEP.
Conclusions:
- Health promotion should advocate for a range of effective and acceptable HIV prevention options, including PrEP.
- Promoting choice in HIV prevention strategies can foster community wellbeing and prevent alienation.
- Rigidly enforcing PrEP as a standard may create community divisions and alienate some individuals.
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