PrEP disclosure and discussions within social networks of people who inject drugs experiencing homelessness: a brief report

BMC Public Health

Research

Seamus Vahey¹  Leah C. Shaw¹  Jennifer K. Brody²  Katie B. Biello³  Angela R. Bazzi⁴ 

[1]Boston Health Care for the Homeless Program, Boston, MA, USA

[2]Boston Health Care for the Homeless Program, Boston, MA, USA

[3]Harvard Medical School, Boston, MA, USA

[4]Departments of Behavioral & Social Sciences and Epidemiology, Brown University School of Public Health, Providence, RI, USA

[5]Center for Health Equity Research, Brown University, Providence, RI, USA

[6]The Fenway Institute, Fenway Health, Boston, MA, USA

[7]Herbert Wertheim School of Public Health, University of California, 9500 Gilman Drive, MTF 265E (Mail Code 0725), 92093, San Diego, La Jolla, CA, USA

[8]Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA

关键词: HIV infections;    Homeless persons;    Substance use, Intravenous;    Pre-exposure prophylaxis;    Social networks;    Disclosure;   

DOI  :  10.1186/s12889-023-15153-5

 received in 2022-06-09, accepted in 2023-01-26,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundIn the context of increasing injection-related HIV outbreaks across the United States, particularly among people who inject drugs (PWID) experiencing homelessness, there is an urgent need to expand access to pre-exposure prophylaxis (PrEP) for HIV prevention. Peer-based interventions for PrEP could be helpful for promoting PrEP uptake, yet the social experiences of using PrEP among PWID experiencing homelessness have not been thoroughly explored.MethodsTo better understand social experiences surrounding PrEP use among PWID experiencing homelessness, we conducted qualitative interviews from March-December 2020 with current and former PrEP patients of an innovative, low-threshold program implemented by Boston Health Care for the Homeless Program (BHCHP) in Boston, MA. Thematic analysis of coded interview data explored participants’ perspectives and experiences with PrEP disclosure and discussions within their social networks.ResultsAmong interviews with 21 participants, we identified the following four interrelated aspects of their social experiences using PrEP: (1) participants’ were aware of increasing HIV transmission within their social networks, which motivated their PrEP use and disclosure; (2)  participants generally avoided disclosing their PrEP use within public spaces or casual conversations; (3)  participants expressed greater willingness to discuss PrEP with their close social contacts; and (4)  some participants self-identified as leaders or expressed interest in leading the dissemination of PrEP information within their social networks.ConclusionsFindings highlight the significance of PrEP disclosure and discussions within the social networks of PWID experiencing homelessness, suggesting a need for continued social network and intervention research—particularly to establish the feasibility and acceptability of peer-based interventions for promoting PrEP—with this marginalized population.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 1