Perceptions of Sexual Risk, PrEP Services, and Peer Navigation Support among HIV-Negative Latinx and Black Men who have Sex with Men (MSM) Residing in Western Washington.
Jahn Jaramillo, Jade Pagkas-Bather, Kimiam Waters, Louis B Shackelford, Russell D Campbell, Jsani Henry, Vanessa Grandberry, Luis F Ramirez, Lorenzo Cervantes, Joanne Stekler, Michele P Andrasik, Susan M Graham
Author Information
Jahn Jaramillo: Department of Global Health, University of Washington, Seattle, WA, USA.
Jade Pagkas-Bather: Department of Medicine, Section of Infectious Diseases & Global Health, The University of Chicago, Chicago, Illinois, USA.
Kimiam Waters: College of Arts & Sciences, University of Washington, Seattle, WA, USA.
Louis B Shackelford: Fred Hutchinson Vaccine and Infectious Disease Division, Seattle, WA, USA.
Russell D Campbell: Fred Hutchinson Vaccine and Infectious Disease Division, Seattle, WA, USA.
Jsani Henry: Public Health- Seattle & King County HIV/STD Program, Seattle, WA, USA.
Vanessa Grandberry: University of Washington, Seattle, WA, USA.
Luis F Ramirez: Latino Community Fund of Washington State, Seattle WA, USA.
Lorenzo Cervantes: Pierce County AIDS Foundation, Tacoma, WA, USA.
Joanne Stekler: Department of Global Health, University of Washington, Seattle, WA, USA.
Michele P Andrasik: Department of Global Health, University of Washington, Seattle, WA, USA.
Susan M Graham: Department of Global Health, University of Washington, Seattle, WA, USA.
Introduction: HIV PrEP (pre-exposure prophylaxis) is underutilized among Latinx and Black men who have sex with men (MSM) in the United States. Although peer navigation approaches may increase PrEP uptake and adherence, it remains unclear what strategies work best for MSM of color. Methods: From July 2017 to August 2018, we conducted semi-structured in-depth interviews with 25 purposively sampled Latinx and Black cisgender MSM to evaluate how the intersectionality of race/ethnicity, sexual orientation, and other identities influenced men's views on PrEP in general and on peer navigation specifically. Thematic analysis was used to identify and analyze emergent themes. Results: Emergent themes included: (1) awareness of vulnerability in intimate relationships; (2) barriers to PrEP initiation including perceived side effects, stigma, and financial concerns; (3) a wish to connect with other Latinx and Black MSM in a health and prevention space; and (4) the desire for peer matching based on identity considerations and lived experience. Younger men and Spanish-speaking Latinx men were most interested in peer navigation to access PrEP, while bisexual men had confidentiality concerns. Conclusions: In our study, Latinx and Black MSM viewed peer navigation services favorably, especially if they addressed men's desire to connect with other MSM of color. Policy Implications: Developing culturally-congruent peer navigation programming could help improve PrEP uptake and care engagement for Latinx and Black MSM. Programs should recruit peers from the racial/ethnic minority communities most impacted by HIV and prioritize matching peers to clients based on identity concerns, needs, and preferences.
