Introduction Pre-exposure prophylaxis (PrEP) is one the most promising HIV interventions, with more than 90% efficacy with consistent adherence. In Guatemala, after more than 10 years of highly financed interventions, MSM continues to be one of the most affected populations for HIV epidemic. Other interventions, mostly behavioural, haven’t changed the course of the HIV epidemic in these population. Our objective was to determinate the acceptability of PrEP in gay men and other MSM in Guatemala city.
Methods Exploratory qualitative study was performed between October and December 2015. 15 MSM were interviewed. Semi-structurated interview of 23 questions regarding: sociodemographic, risk scale, sexual practices and PrEP knowledge. Barriers and facilitators for PrEP were also asked. All participants signed an informed consent. Data analysis was perfomed on Atlas.Ti.
Results Median of age 32 years old, most of the participants reported higher education. Based on CDC guidelines for PrEP, 10 of the participants should be offered PrEP based on their current risks. Condom use was high, and for 3 participants that will be the preferred option always. 13 of them were likely to start PrEP if available, with fears about side effects and cost of the medications. Facilitators for PrEP consumtion was low cost, accessibility of the delivery point, counselling and knowledge about PrEP. To improve adherence, participants recommended phone alarms, text messages, extra pills, flexible or accessible hours for the service.
Conclusion PrEP has a high acceptability among MSM population in Guatemala city. Facilitators and barriers mentions will help to design a successful demonstration project. Based on the reported risks and HIV prevalence in this population, PrEP is an effective needed intervention in these country that can help to change the course of the epidemic. Based on these results, we have started a small fee-based demonstration project since 2016.