Trust, Familiarity, Optimism, and Pleasure: Australian Gay Men Accounting for Inconsistent HIV Prevention Practices in the PrEP Era

Despite an increase in the range of effective HIV risk reduction strategies that are available, some gay and bisexual men (GBM) do not use any of them consistently. Understanding why GBM do not always use a protective strategy may help develop more effective responses. Semi-structured interviews wit...

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Bibliographic Details
Published in:Archives of sexual behavior 2022-07, Vol.51 (5), p.2563-2570
Main Authors: Kolstee, Johann, Prestage, Garrett, Bavinton, Benjamin, Hammoud, Mohamed, Philpot, Steven, Keen, Phillip, Grulich, Andrew, Holt, Martin
Format: Article
Language:English
Subjects:
Behavioral Science and Psychology
Disease prevention
Gays & lesbians
Health behavior
HIV
Human immunodeficiency virus
Mens health
Methadone
Original Paper
Psychology
Public Health
Sexual Behavior
Social Sciences
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Summary:Despite an increase in the range of effective HIV risk reduction strategies that are available, some gay and bisexual men (GBM) do not use any of them consistently. Understanding why GBM do not always use a protective strategy may help develop more effective responses. Semi-structured interviews with 24 sexually active GBM in Sydney, Australia were conducted and analyzed using thematic analysis. The main characteristics of encounters featuring little or no use of HIV risk reduction strategies were familiarity and trust with partners, pleasure and intoxication, expectations that partners were using HIV pre-exposure prophylaxis or treatment as prevention, and in some cases feelings of inevitability about acquiring HIV. An increase in pleasure and a reduction in anxiety about sex were noted by some GBM who had commenced PrEP. Encouraging GBM to adopt a strategy such as PrEP and to use it consistently may be easier by emphasizing benefits to mental health and the quality of sex and intimacy it can offer. However, even with the increased availability of effective biomedical HIV risk reduction strategies, not all GBM are able to consistently manage HIV risk and some continue to hold optimistic and potentially inaccurate beliefs about sexual partners that may increase HIV risk.
ISSN:0004-0002
1573-2800
DOI:10.1007/s10508-021-02203-5