Key factors in the acceptability of Treatment as Prevention (TasP) in Scotland: a qualitative study with communities affected by HIV

Young, I. , Flowers, P. and McDaid, L. (2015) Key factors in the acceptability of Treatment as Prevention (TasP) in Scotland: a qualitative study with communities affected by HIV. Sexually Transmitted Infections, 91(4), pp. 269-274. (doi:10.1136/sextrans-2014-051711) (PMID:25482649)

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Abstract

Objectives: There is a clear need to understand the factors that might prevent and/or facilitate the effective use of HIV treatment as prevention (TasP) at an individual level. This paper reports on findings from the first qualitative study in the UK exploring the acceptability of TasP among gay, bisexual and/or men who have sex with men (MSM) and migrant African communities in Scotland. Methods: We conducted seven exploratory focus group discussions (FGDs) with convenience samples of MSM (five FGDs, n=22) and mixed-gender African (two FGDs, n=11) participants. Of these, three FGDs were conducted with HIV-positive MSM (n=14) and one FGD with HIV-positive Africans (n=8). We then conducted 34 in-depth interviews (IDIs) with a purposive sample of MSM (n=20) and Africans (n=14, women=10). Half were HIV-positive (MSM, n=10; African, n=7). FGD and IDI data were analysed thematically drawing on predetermined and emergent themes. Results: We found that inequalities in HIV literacy could be a barrier to TasP, as could social constraints, such as criminalisation of transmission, increased risk of sexually transmitted infection and increased burden of treatment. We also identified psychological barriers such as perceptions of risk. However, relationships and shared decision making were identified as potential facilitators for TasP. Conclusions: Our results suggest that potential use and management of TasP may not be straightforward. It could be contingent on reducing inequalities in HIV literacy, minimising the perceived burden of treatment and other potential risks, and addressing the dynamics of existing and socially acceptable risk management strategies, especially in relation to long-term serodiscordant relationships.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McDaid, Professor Lisa and Flowers, Professor Paul and Young, Dr Ingrid
Authors: Young, I., Flowers, P., and McDaid, L.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Journal Name:Sexually Transmitted Infections
Publisher:BMJ Publishing Group
ISSN:1368-4973
ISSN (Online):1472-3263
Copyright Holders:Copyright © 2014 The Authors
First Published:First published in Sexually Transmitted Infections
Publisher Policy:Reproduced under a Creative Commons License
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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
656571Sexual Health and Families ProgrammeLisa McdaidMedical Research Council (MRC)MC_UU_12017/2IHW - MRC/CSO SPHU