Official websites use. Share sensitive information only on official, secure websites. Next generation pre-exposure prophylaxis PrEP modalities that do not require daily regimens may address some of the barriers to daily oral PrEP among young men who have sex with men YMSM. We conducted online semi-structured interviews with 30 YMSM to examine experiences and preferences related to HIV prevention care that may inform implementation of next generation PrEP.
Barriers to PrEP care included initiating conversations about sexuality with providers; confidentiality concerns regarding disclosure of sexual practices and PrEP use to family; gaps in access to healthcare; and limited availability of affordable health services. Adolescence and young adulthood are periods marked by exploration of sexual identity and risk-taking, which, coupled with lack of comprehensive sex education, may lead to behaviors associated with HIV transmission, including condomless anal sex [ 2 β 5 ].
Barriers to PrEP use and persistence among MSM in general include concerns related to side effects, cost, medication adherence, and stigma related to PrEP use [ 12 , 13 ]. In addition to challenges experienced by older MSM, YMSM face additional challenges navigating complex health systems, developing trusting patient-provider relationships, and accessing affordable and confidential HIV prevention services, which contribute to poor uptake and adherence to daily oral PrEP in this group [ 10 , 12 , 14 β 16 ].
For example, oral tenofovir-based regimens taken at least two hours before and for two days after sexual encounters i. Other next generation modalities include long-acting oral medications [ 21 ], subdermal implants [ 22 ], rectal douches [ 23 ], and intravenous infusions of broadly neutralizing antibodies bnAb [ 24 , 25 ], all of which are currently being evaluated in phase 1β3 clinical trials.
Behavioral research on investigational products that are currently being evaluated in clinical trials has the potential to optimize clinical trial conduct, and accelerate real-world implementation of PrEP modalities [ 26 , 27 ]. For example, YMSM may have concerns related to side effects of newly-approved products, especially when not familiar with the mode of delivery e.
