HIV incidence is disproportionately high among young cisgender men who have sex with men (YMSM), but YMSM are less likely than adults to use HIV pre-exposure prophylaxis (PrEP). Among YMSM living with HIV, peer navigation programs have been effective in linkage to care and increasing medication adherence; such programs may aid HIV-uninfected YMSM in overcoming barriers to engagement in PrEP care. We conducted 32 semi-structured qualitative interviews at a community health center in Massachusetts, USA, specializing in sexual and gender minority health with four sub-groups of YMSM who: (1) had never discussed PrEP with a medical provider, (2) had discussed PrEP with a medical provider but declined a prescription, (3) were prescribed PrEP and have sub-optimal adherence (taking fewer than 4 pills per week), and (4) were prescribed PrEP and were optimally adherent. Domains addressed in the interviews included knowledge of PrEP and HIV prevention, barriers and facilitators to PrEP adherence, and attitudes toward peer navigation for PrEP. Interviews were transcribed and coded using thematic analysis methodology. Multiple themes emerged from the interviews, including finding that perceived costs, anticipated stigma, sexual activity, and relationship status influence PrEP uptake and adherence; establishing pill-taking routines is an important adherence facilitator; and peer navigators could offer benefits for PrEP adherence.

在年轻的男男性行为者 (YMSM) 中，艾滋病毒发病率异常高，但与成年人相比，YMSM 使用艾滋病毒暴露前预防 (PrEP) 的可能性较小。在感染艾滋病毒的 YMSM 中，同伴导航计划在与护理联系起来和提高药物依从性方面非常有效；此类计划可能会帮助未感染 HIV 的 YMSM 克服参与 PrEP 护理的障碍。我们在美国马萨诸塞州的一个社区健康中心进行了 32 次半结构化定性访谈，该中心专门研究性和性别少数群体的健康，其中包括 YMSM 的四个亚组：(1) 从未与医疗提供者讨论过 PrEP，(2) 曾经讨论过 PrEP。与医疗服务提供者讨论了 PrEP，但拒绝了处方，(3) 接受了 PrEP 处方，但依从性不佳（每周服用少于 4 粒药片），(4) 接受了 PrEP 治疗并且依从性最佳。访谈涉及的领域包括 PrEP 和 HIV 预防的知识、坚持 PrEP 的障碍和促进因素，以及对 PrEP 同伴导航的态度。使用主题分析方法对访谈进行转录和编码。访谈中出现了多个主题，包括发现感知成本、预期耻辱、性活动和关系状态影响 PrEP 的采用和坚持；建立服药习惯是重要的依从性促进因素；同行导航器可以为 PrEP 依从性带来好处。使用主题分析方法对访谈进行转录和编码。访谈中出现了多个主题，包括发现感知成本、预期耻辱、性活动和关系状态影响 PrEP 的采用和坚持；建立服药习惯是重要的依从性促进因素；同行导航器可以为 PrEP 依从性带来好处。使用主题分析方法对访谈进行转录和编码。访谈中出现了多个主题，包括发现感知成本、预期耻辱、性活动和关系状态影响 PrEP 的采用和坚持；建立服药习惯是重要的依从性促进因素；同行导航器可以为 PrEP 依从性带来好处。