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Social, structural, behavioral and clinical factors influencing retention in Pre-Exposure Prophylaxis (PrEP) care in Mississippi

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Listed:
  • Trisha Arnold
  • Lauren Brinkley-Rubinstein
  • Philip A Chan
  • Amaya Perez-Brumer
  • Estefany S Bologna
  • Laura Beauchamps
  • Kendra Johnson
  • Leandro Mena
  • Amy Nunn

Abstract

Pre-exposure prophylaxis (PrEP) is a biomedical intervention that can reduce rates of HIV transmission when taken once daily by HIV-negative individuals. Little is understood about PrEP uptake and retention in care among the populations most heavily impacted by the HIV epidemic, particularly among young men who have sex with men (YMSM) in the Deep South. Therefore, this study explored the structural, social, behavioral, and clinical factors that affect PrEP use and retention in care among YMSM in Jackson, Mississippi. Thirty MSM who were prescribed PrEP at an outpatient primary care clinic were interviewed and included 23 men who had been retained in PrEP care and seven who had not been retained. The mean age of participants was 26.6 years. Most (23) participants were African American. Major factors affecting PrEP use and retention in PrEP care included 1) structural factors such as cost and access to financial assistance for medications and clinical services; 2) social factors such as stigma and relationship status; 3) behavioral factors including sexual risk behaviors; and 4) clinical factors such as perceived and actual side effects. Many participants also discussed the positive spillover effects of PrEP use and reported that PrEP had a positive impact on their health. Four of the seven individuals who had not been retained re-enrolled in PrEP care after completing their interviews, suggesting that case management and ongoing outreach can enhance retention in PrEP care. Interventions to enhance retention in PrEP care among MSM in the Deep South will be most effective if they address the complex structural, social, clinical, and behavioral factors that influence PrEP uptake and retention in PrEP care.

Suggested Citation

  • Trisha Arnold & Lauren Brinkley-Rubinstein & Philip A Chan & Amaya Perez-Brumer & Estefany S Bologna & Laura Beauchamps & Kendra Johnson & Leandro Mena & Amy Nunn, 2017. "Social, structural, behavioral and clinical factors influencing retention in Pre-Exposure Prophylaxis (PrEP) care in Mississippi," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-10, February.
  • Handle: RePEc:plo:pone00:0172354
    DOI: 10.1371/journal.pone.0172354
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    Cited by:

    1. Omar Nieto & Ronald A Brooks & Amanda Landrian & Alejandra Cabral & Anne E Fehrenbacher, 2020. "PrEP discontinuation among Latino/a and Black MSM and transgender women: A need for PrEP support services," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-13, November.
    2. Salabarría-Peña, Yamir & Douglas, Chelsea & Brantley, Meredith & Johnson, Amy K., 2022. "Informing the future of PrEP navigation: Findings from a five-site cluster evaluation," Evaluation and Program Planning, Elsevier, vol. 90(C).
    3. Christopher Chauncey Watson & Leo Wilton & Jonathan Paul Lucas & Lawrence Bryant & Gregory D. Victorianne & Kerry Aradhya & Sheldon D. Fields & Darrell P. Wheeler & on behalf of the HPTN Black Caucus, 2020. "Development of a Black Caucus within the HIV Prevention Trials Network (HPTN): Representing the Perspectives of Black Men Who Have Sex with Men (MSM)," IJERPH, MDPI, vol. 17(3), pages 1-16, February.
    4. Andrew Spieldenner & Anthony J. Santella & Spring C. Cooper & Kathleen Rosales & William C. Goedel & Heidi E. Jones, 2022. "Knowledge, Attitudes, and Practices towards PrEP from Cisgender Men and Transgender Women Who Have Sex with Men in the Largest Suburban HIV Epidemic," IJERPH, MDPI, vol. 19(18), pages 1-10, September.

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