TY - JOUR
T1 - Insights into barriers and facilitators in PrEP uptake and use among migrant men and transwomen who have sex with men in Belgium
AU - Van Landeghem, Ella
AU - Dielen, Stef
AU - Semaan, Aline
AU - Rotsaert, Anke
AU - Vanhamel, Jef
AU - Masquillier, Caroline
AU - Wouters, Edwin
AU - Wouters, Kristien
AU - Vuylsteke, Bea
AU - Reyniers, Thijs
AU - Nöstlinger, Christiana
N1 - FTX; DOAJ; (CC BY 4.0); © 2023. The Author(s).
PY - 2023
Y1 - 2023
N2 - BACKGROUND: PrEP 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.METHODS: We 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.RESULTS: We 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.CONCLUSION: An 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.
AB - BACKGROUND: PrEP 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.METHODS: We 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.RESULTS: We 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.CONCLUSION: An 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.
KW - Male
KW - Humans
KW - Homosexuality, Male/psychology
KW - HIV Infections/drug therapy
KW - Belgium
KW - Transients and Migrants
KW - Sexual and Gender Minorities
KW - Pre-Exposure Prophylaxis
KW - Anti-HIV Agents/therapeutic use
U2 - 10.1186/s12889-023-15540-y
DO - 10.1186/s12889-023-15540-y
M3 - A1: Web of Science-article
C2 - 37076823
SN - 1471-2458
VL - 23
JO - BMC Public Health
JF - BMC Public Health
IS - 1
M1 - 712
ER -