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Experiences of HIV postexposure prophylaxis (PEP) among highly exposed men who have sex with men (MSM)
  1. Romain Palich1,2,
  2. Guillaume Martin-Blondel1,3,
  3. Lise Cuzin4,5,6,
  4. Jean-Yves Le Talec7,
  5. Pierre Boyer2,
  6. Patrice Massip1,
  7. Pierre Delobel1,3
  1. 1Service des Maladies Infectieuses et Tropicales, CHU Toulouse-Purpan, Toulouse, France
  2. 2Departement de Medecine Generale, Faculte de Medecine Toulouse-Rangueuil, Toulouse, France
  3. 3INSERM U1043 - CNRS UMR 5282, Centre de Physiopathologie Toulouse-Purpan, Toulouse, France
  4. 4Universite de Toulouse III, Toulouse, France
  5. 5COREVIH de Toulouse, CHU Toulouse-Purpan, Toulouse, France
  6. 6INSERM UMR 1027, Toulouse, France
  7. 7CERTOP UMR 5044, CNRS et Universite Toulouse Jean Jaures, Toulouse, France
  1. Correspondence to Dr Romain Palich, service des Maladies Infectieuses et Tropicales, CHU Toulouse-Purpan, Placedu Docteur Baylac, TSA 40031, Toulouse 31069, France; romain.palich{at}gmail.com

Abstract

Objectives HIV postexposure prophylaxis (PEP) is indicated after sexual exposure with high risk of transmission. Men who have sex with men (MSM) are the main target of PEP. The aim of our study was to investigate the experience and shortcomings of PEP among people with a high risk of HIV exposure.

Design and methods Subjects with ongoing follow-up for HIV infection and PEP history were selected for the qualitative study. Semistructured interviews were conducted at the patients' homes. They were audio-recorded, transcribed and deidentified before data analysis, double coding and thematic analysis with an inductive approach.

Results Twenty-three patients were eligible for the qualitative study. Thirteen interviews were carried out. All patients were 20-60-year-old MSM. The median time between PEP and HIV diagnosis was 3.3 years (interquartile range (IQR)25-75=0.9-4.9). Many participants reported negative PEP experiences: awkward access to the PEP clinic, uneasiness and shame in the hospital setting, unpleasant interaction and moral disapprobation from the medical staff, treatment intolerance and prevention messages that were 'inconsistent with real life'

Conclusion Our data highlight PEP management failures among its target population that may have compromised any subsequent attempts to seek out PEP. Practitioners should be more aware of MSM sexual contexts and practices. PEP consultations should provide the opportunity to discuss prevention strategies with highly exposed HIV-negative subjects, which may include pre-exposure prophylaxis.

  • postexposure prophylaxis (hiv)
  • hiv
  • qualitative research
  • homosexuality
  • sexual behaviour

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Footnotes

  • Handling editor Jackie A Cassell

  • Contributors RP, GM-B and LC conceived the question for this study. RP undertook the data collection, designed and performed the data analysis and wrote the first draft of the article. J-YLT performed the data analysis. All authors contributed to data interpretation, commented on and approved the final draft.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Ethics Committee of Toulouse University (number TOU3-1073).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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