U2 What do men who have sex with men (MSM) taking post-exposure prophylaxis (PEP) for hiv following sexual exposure report about their recent sexual risk-taking behaviour?

Abstract

Background/introduction High‐risk sexual behaviour plays a significant role in the increasing incidence of HIV infection among men who have sex with men (MSM) in the UK, despite the availability of post‐exposure prophylaxis following sexual exposure (PEPSE). Aim(s)/objectives Behavioural interventions to encourage safer sexual practices need to be effective and acceptable for their target population. Therefore, this study aims to identify the attitudes and interpretation of risk of MSM taking PEPSE. Methods Data was collected as part of an ongoing randomised controlled trial evaluating a psychological intervention in reducing risk behaviour amongst MSM prescribed PEPSE. The intervention group received two 30‐minute telephone interventions implementing augmented motivational interviewing. In this study, 30 participants were selected from the intervention arm and their interventions analysed for thematic content. Results Themes included: circumstances of event that led to PEPSE; participant's interpretation of risk; emotions associated with risk; disclosure of HIV status; value attributed to consequences of risk; and reason for seeking PEPSE. Discussion/conclusion Risks were mostly reported in the context of unprotected anal intercourse (UAI) with casual partners, without discussion of HIV status. One theme that arose was the use of mobile‐phone applications to seek casual sexual partners. Reasons given for engaging in UAI included anxiety over suggesting condom use, engaging in UAI as a form of “self‐harm”, and alcohol intoxication. Concern about the morbidity and stigma associated with HIV and the desire for relationships were motivating factors for avoiding HIV. PEPSE was frequently described as an insight into life‐long antiretroviral therapy for HIV infection.