Acceptability of Biomedical HIV Prevention
Since the beginning of the HIV epidemic, efforts have been made to find a biomedical intervention to prevent HIV transmission. While an effective vaccine has proven elusive, recent developments in the use of antiretroviral drugs for the prevention of sexual transmission of HIV have shown promise. Studies of pre-exposure chemoprophylaxis (antiretroviral drugs taken by HIV-negative individuals) and microbicides (an antiretroviral gel applied topically to the vagina or rectum) have recently displayed promising results in reducing rates of HIV transmission. There is also growing interest in ‘treatment as prevention’, whereby people living with HIV take antiretroviral drugs in order to reduce HIV transmission in HIV-negative sexual partners. This intervention has already been effectively used to reduce and/or eliminate HIV transmission between an HIV-positive mother and child. However, a recent study found that HIV transmission between sexual partners was significantly less likely where HIV-positive individuals started treatment immediately, rather than in those who delayed the start of treatment. These findings could have major implications for future HIV prevention. However, it is not yet known if these types of interventions would be acceptable to populations most affected by HIV in Scotland (gay & bisexual men, and men & women from migrant African communities).
Ingrid Young recently completed this qualitative study with communities most affected by HIV in Scotland. This study explored if and how new uses of antiretroviral drugs might be acceptable to people living with or at risk of HIV and how these new interventions can be used in combination with other behavioural interventions for HIV prevention. Ingrid worked closely with a number of clinical and community development partners in the design and implementation of this research. The study was comprised of seven focus groups (33 participants) and in-depth interviews (34 participants), including people living with HIV and HIV-negative and/or untested individuals. Findings highlight the importance of risk perception to PrEP and TasP candidacy, HIV-related stigma, and wider community attitudes to HIV prevention. Findings also suggest there is a need to consider how clinical research is translated into real world contexts and communicated to potential users, as well as how potential users are supported in integrating this information into existing risk management strategies. For more information on this research, see the project website.
Young I, Flowers P, McDaid L. Key factors in the acceptability of Treatment as Prevention (TasP) in Scotland: a qualitative study with communities affected by HIV. BMJ Sexually Transmitted Infections 2015;91:269-74open access
Young I, Flowers P, McDaid L. Barriers to uptake and use of Pre-Exposure Prophylaxis (PrEP) amongst communities most affected by HIV in the UK: findings from a qualitative study in Scotland. BMJ Open 2014;4:e005717open access
Young I, McDaid L. How acceptable are antiretrovirals for the prevention of sexually transmitted HIV? A review of research on the acceptability of oral pre-exposure prophylaxis and treatment as prevention. AIDS & Behavior 2014;18:195-216open access
Young I, Li J, McDaid L. Awareness and willingness to use HIV Pre-exposure Prophylaxis amongst gay and bisexual men in Scotland: implications for biomedical HIV prevention. PLoS One 2013;8:e64038open access