Insights into barriers and facilitators in PrEP uptake and use among migrant men and transwomen who have sex with men in Belgium

BMC Public Health

卷:23

Research

Kristien Wouters¹  Stef Dielen²  Aline Semaan²  Bea Vuylsteke²  Thijs Reyniers²  Christiana Nöstlinger²  Ella Van Landeghem²  Jef Vanhamel²  Anke Rotsaert²  Caroline Masquillier³  Edwin Wouters³ 

[1] Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium;

[2] Department of Public Health, Institute of Tropical Medicine Nationalestraat 155, 2000, Antwerp, Belgium;

[3] Department of Sociology, University of Antwerp, Antwerp, Belgium;

关键词: HIV prevention;    PrEP;    Access to health care;    Migrants;    Belgium;   

DOI  :  10.1186/s12889-023-15540-y

 received in 2022-10-26, accepted in 2023-03-27,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPrEP uptake is low among non-Belgian men and transwomen who have sex with men, although the HIV epidemic among men who have sex with men in Belgium is diversifying in terms of nationalities and ethnicity. We lack an in-depth understanding of this gap.MethodsWe conducted a qualitative study using a grounded theory approach. The data consists of key informants interviews and in-depth interviews with migrant men or transwomen who have sex with men.ResultsWe identified four underlying determinants which shape our participants’ experiences and contextualize the barriers to PrEP use. These include (1) the intersectional identities of being migrant and men and transwomen who have sex with men, (2) migration related stressors, (3) mental health and (4) socio-economic vulnerability. Identified barriers include: the accessibility of services; availability of information, social resources and providers’ attitudes. These barriers influence PrEP acceptance and mediated by individual agency this influences their PrEP uptake.ConclusionAn interplay of several underlying determinants and barriers impacts on PrEP uptake among migrant men and transwomen who have sex with men, illustrating a social gradient in access to PrEP. We need equitable access to the full spectrum of HIV prevention and care for all priority populations, including undocumented migrants. We recommend social and structural conditions that foster exercising these rights, including adapting PrEP service delivery, mental health and social support.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 4