DIY HIV prevention: Formative qualitative research with men who have sex with men who source PrEP outside of clinical trials

Pre-exposure prophylaxis (PrEP) with antiretroviral medication is an effective, evidence-based option for HIV prevention. In England, issues of cost-effectiveness and of responsibility for commissioning prevention services have so far led National Health Service (NHS) England to decide not to commis...

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Bibliographic Details
Published in:	PloS one Vol. 13; no. 8; p. e0202830
Main Authors:	Paparini, Sara, Nutland, Will, Rhodes, Tim, Nguyen, Vinh-Kim, Anderson, Jane
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 23.08.2018 Public Library of Science (PLoS)
Subjects:	Acquired immune deficiency syndrome Adult AIDS Anti-HIV agents Anti-HIV Agents - therapeutic use Anti-Retroviral Agents - therapeutic use Antiretroviral agents Antiretroviral drugs Antiretroviral therapy Biology and Life Sciences Clinical research Clinical trials Clinics Commissioning Computer and Information Sciences Cost analysis Disease prevention Dosage Dosage and administration Drugs Efficacy Environmental health Focus Groups Formulations Gays & lesbians Generic prescribing Health aspects Health care Health services Health Services Accessibility Hepatitis HIV HIV infections HIV Infections - prevention & control Human immunodeficiency virus Humans Internet Intervention Legitimacy LGBTQ people London Male Medical research Medicine and Health Sciences Men Men who have sex with men Mens health Merchants Middle Aged MSM (Men who have sex with men) People and places Pre-Exposure Prophylaxis Prevention Prevention programs Preventive medicine Prophylaxis Public health Qualitative Research Research and Analysis Methods Self Medication Self-Help Groups Sex Sexual and Gender Minorities Sexuality Sexually transmitted diseases Sociology STD Studies London Scotland United Kingdom > UK France United States > US Switzerland
ISSN:	1932-6203, 1932-6203
Online Access:	Get full text
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Summary:	Pre-exposure prophylaxis (PrEP) with antiretroviral medication is an effective, evidence-based option for HIV prevention. In England, issues of cost-effectiveness and of responsibility for commissioning prevention services have so far led National Health Service (NHS) England to decide not to commission PrEP. Given the significant lag between the awareness of PrEP efficacy and the opportunity to obtain PrEP through traditional health care routes, many gay and other men who have sex with men (MSM) have turned to 'DIY PrEP', purchasing generic formulations of PrEP for themselves on the internet or via other alternative routes. However, there is very little research on DIY PrEP practices and no qualitative study with DIY PrEP users in the UK. A formative qualitative study was conducted in 2017 to inform the development of an intervention (PrEP Club) to support DIY PrEP users and improve the safety and experience of this prevention strategy. Focus groups were held with 20 MSM who are based in London and are obtaining PrEP through means other than clinical trials, to explore their accounts of sourcing and using PrEP and the experiential meanings of these. In this article, we report findings from this first, formative study and present the different practices involved in finding out about PrEP, buying it and ascertaining legitimacy of sellers and products. We reflect on the uncertainties participants described related to actually using PrEP, including deciding on drug dosing and monitoring their health. Finally, we present the results of the discussions participants had about the kind of support they had received, the help they would have liked, and their views on proposed interventions to support DIY PrEP users, such as PrEP Club.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Competing Interests: The authors have declared that no competing interests exist. SP has received speaker honoraria from ViiV HealthCare. JA has received speaker honoraria from Gilead Science, Merck Sharp Dohm, conference attendance support and consultancy fees from Gilead Sciences. VKN has received speaker honoraria from Gilead France. WN is the founder of PrEPster, a community based organisations that has received grants from MAC Aids Fund, Elton John AIDS Foundation, and Public Health England. WN has received personal travel grants from AVAC and speaker honoraria from the Thai Red Cross. This does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0202830