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“It’s Very Inconvenient for Me”: A Mixed-Method Study Assessing Barriers and Facilitators of Adolescent Sexual Minority Males Attending PrEP Follow-Up Appointments

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Abstract

Researching PrEP retention in adolescent sexual minority men (ASMM) is critical to increasing persistence of PrEP in this priority population, yet this research is lacking. ASMM (N = 1433) completed a baseline survey for an online HIV prevention program between 2018 and 2020. Open- and closed-ended survey items identified their beliefs about attending 3-month PrEP follow-up appointments and examined the association of Andersen’s Behavioral Model factors (predisposing, enabling, and need) and confidence to attend these appointments. Qualitative and quantitative findings show that perceived parental support is a salient factor in ASMM attending PrEP follow-up appointments. Participants did not want to have to go to the doctor and get bloodwork done trimonthly, and qualitative findings elucidated rationales for this, such as perceptions that follow-ups might be time-consuming, costly, and could out their sexuality to their parents. This study suggests that parents are gatekeepers for ASMM to initiate and sustain the PrEP care continuum.

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Acknowledgements

This work was supported by a grant from the National Institute on Minority Health and Health Disparities (U01MD011281; PI: Mustanski). The sponsor had no involvement in conducting the research or preparing of the paper for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The authors would like to thank the SMART Youth Advisory Council and the study participants for their time.

Funding

This work was supported by a grant from the National Institute on Minority Health and Health Disparities (U01MD011281; PI: Mustanski). The sponsor had no involvement in conducting the research or preparing of the paper for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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Authors and Affiliations

  1. Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Suite 1400, Chicago, IL, 60611, USA

    Christopher Owens, Kevin Moran, Melissa Mongrella, David A. Moskowitz, Brian Mustanski & Kathryn Macapagal

  2. Department of Medical Social Sciences, Northwestern University, 633 N. Saint Clair St, 19th Floor , Chicago, IL, 60611, USA

    David A. Moskowitz, Brian Mustanski & Kathryn Macapagal

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  1. Christopher Owens
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  2. Kevin Moran
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  3. Melissa Mongrella
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  4. David A. Moskowitz
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  6. Kathryn Macapagal
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Contributions

All authors contributed to the study conception and design. Conceptualization was performed by Macapagal and Owens. Data analysis was performed by Moran, Mongrella, and Owens. Original writing and editing was performned by Macapagapl, Moran, Mongrella, Mustanksi, and Owens.

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Correspondence to Christopher Owens.

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All procedures were approved by the Northwestern University institutional review board. The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Owens, C., Moran, K., Mongrella, M. et al. “It’s Very Inconvenient for Me”: A Mixed-Method Study Assessing Barriers and Facilitators of Adolescent Sexual Minority Males Attending PrEP Follow-Up Appointments. AIDS Behav 26, 21–34 (2022). https://doi.org/10.1007/s10461-021-03313-w

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