{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T17:19:37Z","timestamp":1785518377709,"version":"3.56.0"},"reference-count":29,"publisher":"BMJ","issue":"4","funder":[{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["200172\/Z\/15\/Z"],"award-info":[{"award-number":["200172\/Z\/15\/Z"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2019,1,26]]},"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Black men who have sex with men (BMSM) have higher HIV incidence and prevalence when compared with other men who have sex with men, despite similar risk profiles. New prevention technologies, including pre-exposure prophylaxis (PrEP), may be effective in responding to these inequalities, provided they are appropriately targeted and acceptable to their intended beneficiaries. This study aims to understand the motivations and barriers of BMSM aged 18\u201345 to PrEP uptake.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty-five BMSM recruited through geolocation social networking apps took part in in-depth interviews between April and August 2016. Intersectionality theory was used as an organising principle. Interviews were transcribed verbatim and analysed using a thematic framework analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For BMSM with heterogeneous social groups, discussions about sexual health were challenging because of the intersection of ethnic background, family history and religion. This limited conversations about PrEP to gay male friends who often held stigmatising views of condomless anal intercourse. BMSM reported exclusion from gay male spaces (online and offline) which could serve to restrict exposure to PrEP messages. Stereotypes of BMSM intersected with negative conceptions of PrEP users, limiting acknowledgement of PrEP candidacy. For those who had attempted to or successfully accessed it, PrEP was framed as a strategy to mitigate risk and to guard against further stigma associated with HIV infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>BMSM operate within a complex set of circumstances related to the intersection of their sexual, ethnic, cultural and religious identities, which shape PrEP acceptability. Interventions which seek to facilitate uptake in this group must be attentive to these. Health promotion and clinical services could seek to facilitate nuanced discussions about the merits of PrEP for those at frequent risk, perhaps while also providing publicly visible PrEP role models for BMSM and other marginalised groups.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2018-053773","type":"journal-article","created":{"date-parts":[[2019,3,4]],"date-time":"2019-03-04T16:15:11Z","timestamp":1551716111000},"page":"262-266","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":38,"title":["What are the motivations and barriers to pre-exposure prophylaxis (PrEP) use among black men who have sex with men aged 18\u201345 in London? Results from a qualitative study"],"prefix":"10.1136","volume":"95","author":[{"given":"T Charles","family":"Witzel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Will","family":"Nutland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Bourne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,3,4]]},"reference":[{"key":"2024092304500961000_95.4.262.1","doi-asserted-by":"crossref","unstructured":"Brown AE , Mohammed H , Ogaz D , et al . Fall in new HIV diagnoses among men who have sex with men (MSM) at selected London sexual health clinics since early 2015: testing or treatment or pre-exposure prophylaxis (PreP)? Euro Surveill. 2017;22.doi:10.2807\/1560-7917.ES.2017.22.25.30553","DOI":"10.2807\/1560-7917.ES.2017.22.25.30553"},{"key":"2024092304500961000_95.4.262.2","unstructured":"Delpech V , Desai M . Towards elimination of HIV amongst gay and bisexual men in the United Kingdom. 23rd annual conference of BHIVA, 2017."},{"key":"2024092304500961000_95.4.262.3","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1111\/hiv.12498","article-title":"HIV incidence in an open national cohort of men who have sex with men attending sexually transmitted infection clinics in England","volume":"18","author":"Desai","year":"2017","journal-title":"HIV Med"},{"key":"2024092304500961000_95.4.262.4","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2016-052800"},{"key":"2024092304500961000_95.4.262.5","doi-asserted-by":"publisher","DOI":"10.1016\/ S0140-6736(12)60899-X"},{"key":"2024092304500961000_95.4.262.6","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2016-052912"},{"key":"2024092304500961000_95.4.262.7","unstructured":"Brown AE , Kirwan P , Chau C , et al . Towards elimination of HIV transmission, AIDS and HIV-related deaths in the UK - 2017 report. London: Public Health England, 2017."},{"key":"2024092304500961000_95.4.262.8","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/S0140-6736(15)00056-2","article-title":"Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial","volume":"387","author":"McCormack","year":"2016","journal-title":"The Lancet"},{"key":"2024092304500961000_95.4.262.9","doi-asserted-by":"crossref","unstructured":"Anderson PL , Glidden DV , Liu A , et al . Emtricitabine-Tenofovir concentrations and pre-exposure prophylaxis efficacy in men who have sex with men. Science Translational Medicine 2012;4.doi:10.1126\/scitranslmed.3004006","DOI":"10.1126\/scitranslmed.3004006"},{"key":"2024092304500961000_95.4.262.10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1506273"},{"key":"2024092304500961000_95.4.262.11","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001145"},{"key":"2024092304500961000_95.4.262.12","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2015-052382"},{"key":"2024092304500961000_95.4.262.13","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.4683"},{"key":"2024092304500961000_95.4.262.14","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0175596","article-title":"Acceptability of an open-label wait-listed trial design: experiences from the PROUD PreP study","volume":"12","author":"Gafos","year":"2017","journal-title":"PLoS One"},{"key":"2024092304500961000_95.4.262.15","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0202830","article-title":"DIY HIV prevention: formative qualitative research with men who have sex with men who source PreP outside of clinical trials","volume":"13","author":"Paparini","year":"2018","journal-title":"Plos One"},{"key":"2024092304500961000_95.4.262.16","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2012.0419"},{"key":"2024092304500961000_95.4.262.17","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0064038","article-title":"Awareness and willingness to use HIV pre-exposure prophylaxis amongst gay and bisexual men in Scotland: implications for biomedical HIV prevention","volume":"8","author":"Young","year":"2013","journal-title":"PLoS ONE"},{"key":"2024092304500961000_95.4.262.18","doi-asserted-by":"crossref","unstructured":"Jaspal R , Daramilas C . Perceptions of pre-exposure prophylaxis (PreP) among HIV-negative and HIV-positive men who have sex with men (MSM). Cogent Med 2016;3.doi:10.1080\/2331205X.2016.1256850","DOI":"10.1080\/2331205X.2016.1256850"},{"key":"2024092304500961000_95.4.262.19","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1007\/s10461-016-1627-z","article-title":"Values and preferences on the use of oral pre-exposure prophylaxis (PreP) for HIV prevention among multiple populations: a systematic review of the literature","volume":"21","author":"Koechlin","year":"2017","journal-title":"AIDS Behav"},{"key":"2024092304500961000_95.4.262.20","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1007\/s10461-017-1964-6","article-title":"Sex, PREP, and stigma: experiences with HIV pre-exposure prophylaxis among New York City MSM participating in the HPTN 067\/ADAPT study","volume":"22","author":"Franks","year":"2018","journal-title":"AIDS Behav"},{"key":"2024092304500961000_95.4.262.21","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1111\/1467-9566.12372","article-title":"Can a pill prevent HIV? negotiating the biomedicalisation of HIV prevention","volume":"38","author":"Young","year":"2016","journal-title":"Sociol Health Illn"},{"key":"2024092304500961000_95.4.262.22","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1177\/0956462418755224","article-title":"What qualities in a potential HIV pre-exposure prophylaxis service are valued by black men who have sex with men in London? A qualitative acceptability study","volume":"29","author":"Witzel","year":"2018","journal-title":"Int J STD AIDS"},{"key":"2024092304500961000_95.4.262.23","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2012.300750"},{"key":"2024092304500961000_95.4.262.24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5153\/sro.1652","article-title":"Navigating Queer street: researching the Intersections of Lesbian, gay, bisexual and trans (LGBT) identities in health research","volume":"13","author":"Fish","year":"2008","journal-title":"Sociol Res Online"},{"key":"2024092304500961000_95.4.262.25","doi-asserted-by":"crossref","unstructured":"Clarke V , Braun V , Analysis T . Thematic Analysis. In: Teo T , ed. Encyclopedia of critical psychology. New York: Springer New York, 2014: 1947\u201352.","DOI":"10.1007\/978-1-4614-5583-7_311"},{"key":"2024092304500961000_95.4.262.26","unstructured":"Ritchie J , Spencer L . Qualitative Data Analysis for Applied Policy Research. In: Bryman A , Burgess RG , eds. Analyzing qualitative data. Abingdon, UK: Taylor & Francis Books Ltd, 1994."},{"key":"2024092304500961000_95.4.262.27","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1007\/s10461-017-1675-z","article-title":"A global estimate of the acceptability of pre-exposure prophylaxis for HIV among men who have sex with men: a systematic review and meta-analysis","volume":"22","author":"Peng","year":"2018","journal-title":"AIDS Behav"},{"key":"2024092304500961000_95.4.262.28","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1089\/apc.2015.0002","article-title":"Getting prepared for HIV prevention navigation: young black gay men talk about HIV prevention in the biomedical era","volume":"29","author":"Mutchler","year":"2015","journal-title":"AIDS Patient Care STDS"},{"key":"2024092304500961000_95.4.262.29","doi-asserted-by":"crossref","unstructured":"Witzel TC , Melendez-Torres GJ , Hickson F , et al . HIV testing history and preferences for future tests among gay men, bisexual men and other MSM in England: results from a cross-sectional study. BMJ Open 2016;6.doi:10.1136\/bmjopen-2016-011372","DOI":"10.1136\/bmjopen-2016-011372"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2018-053773","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T11:50:26Z","timestamp":1727092226000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2018-053773"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,4]]},"references-count":29,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019,5,16]]},"published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1136\/sextrans-2018-053773"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2018-053773","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,4]]}}}