Abstract

Despite significant advances in the HIV treatment and prevention landscape such as pre-exposure prophylaxis (PrEP), young Black-Canadian gay, bisexual and other sexual minority men continue to experience disproportionately high rates of HIV infection. While research has explored the factors associated with their higher HIV exposure and the efficacy of STI/HIV prevention programmes, there remains a paucity of research on their knowledge of HIV prevention strategies such as PrEP. We interviewed twenty-two young men and used a constructivist grounded theory approach to qualitatively analyse these young men’s PrEP knowledge. Intersectionality and the social ecological model allowed us to explore how social locations (e.g. race, sexual orientation), interacted with individual, interpersonal and community contexts to shape their understanding. Our analysis revealed two interrelated barriers to PrEP knowledge and uptake. The first centred on the ineffectiveness of institutions in disseminating PrEP information to participants. The second focused on the impact of participants’ social locations and perceptions of PrEP users based on their PrEP knowledge. Findings suggest the need for more targeted, culturally congruent PrEP dissemination strategies and PrEP prescription policies that acknowledge the various social locations and ecologies in which young Black gay, bisexual and other men who have sex with men reside.

摘要

尽管 HIV 治疗和预防领域取得了重大进展，例如暴露前预防 (PrEP)，但年轻的加拿大黑人男同性恋、双性恋和其他性少数群体男性的 HIV 感染率仍然过高。虽然研究已经探索了与他们较高的 HIV 暴露和 STI/HIV 预防计划的功效相关的因素，但关于他们对 HIV 预防策略（如 PrEP）的知识的研究仍然很少。我们采访了 22 名年轻男性，并使用基于建构主义的理论方法来定性分析这些年轻男性的 PrEP 知识。交叉性和社会生态模型使我们能够探索社会位置（例如种族、性取向）如何与个人、人际和社区环境相互作用以形成他们的理解。我们的分析揭示了 PrEP 知识和吸收的两个相互关联的障碍。第一个集中在机构在向参与者传播 PrEP 信息方面的无效性。第二个重点关注参与者的社交位置和基于他们的 PrEP 知识对 PrEP 用户的看法的影响。调查结果表明，需要更有针对性、文化上一致的 PrEP 传播策略和 PrEP 处方政策，以承认年轻的黑人同性恋、双性恋和其他男男性行为者居住的各种社会位置和生态环境。第二个重点关注参与者的社交位置和基于他们的 PrEP 知识对 PrEP 用户的看法的影响。调查结果表明，需要更有针对性、文化上一致的 PrEP 传播策略和 PrEP 处方政策，以承认年轻的黑人同性恋、双性恋和其他男男性行为者居住的各种社会位置和生态环境。第二个重点关注参与者的社交位置和基于他们的 PrEP 知识对 PrEP 用户的看法的影响。调查结果表明，需要更有针对性、文化上一致的 PrEP 传播策略和 PrEP 处方政策，以承认年轻的黑人同性恋、双性恋和其他男男性行为者居住的各种社会位置和生态环境。