Strategies to support HIV literacy in the roll-out of pre-exposure prophylaxis in Scotland: findings from qualitative research with clinical and community practitioners

Young, I. and Valiotis, G. (2020) Strategies to support HIV literacy in the roll-out of pre-exposure prophylaxis in Scotland: findings from qualitative research with clinical and community practitioners. BMJ Open, 10(4), e033849. (doi: 10.1136/bmjopen-2019-033849) (PMID:32350011) (PMCID:PMC7213852)

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Objectives: Limited understanding of pre-exposure prophylaxis (PrEP), coupled with negative public discourse, are significant barriers to its introduction. What works to support PrEP awareness and broader HIV literacy among diverse communities in the context of biomedical HIV prevention remains unclear. This article considers how PrEP can be translated across diverse communities and what the HIV literacy challenges might be in the current context of PrEP provision. Setting: We developed an HIV literacy informed community tool to support the roll-out of PrEP in Scotland. We undertook qualitative research with practitioners in urban and rural settings across nine Scottish health boards. Primary outcome measure: To examine HIV literacy challenges in the context of PrEP provision. Participants: Interviews and focus groups with community (n=19) and clinical (n=13) practitioners working with gay and bisexual men and African communities were undertaken between March and October 2017 concerning PrEP support, stigma and HIV literacy. Results: HIV literacy in the context of PrEP needs to consider more than the provision of individually targeted information. Practitioners identified and responded to stratified communities and social norms of knowledge, which influenced messaging, support and informed how practitioners enabled PrEP engagement and dialogue. Social barriers in HIV literacy, including structural stigmas relating to HIV and homophobia, shaped practitioner concerns and support for community members’ willingness to engage with PrEP. Conclusion: Critical HIV literacy in the age of PrEP is a complex social practice. Attention needs to be paid to how information is provided and facilitates engagement, rather than simply what information is given.By exploring practitioner use of the Know about PrEP tool, we have shown how consideration of the patterns of access to services and information, the delivery of and support for engagement with PrEP information and the wider strategies employed to negotiate ongoing structural social barriers can support more equitable and diverse PrEP community conversations.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Young, Dr Ingrid
Authors: Young, I., and Valiotis, G.
College/School:College of Social Sciences > School of Social and Political Sciences
Journal Name:BMJ Open
Publisher:BMJ Publishing Group
ISSN (Online):2044-6055
Published Online:28 April 2020
Copyright Holders:Copyright © 2020 The Authors
First Published:First published in BMJ Open 10(4): e033849
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
170578Addressing HIV literacy and inequalities in an era of biomedical HIV prevention: supporting the wellbeing of communities most affected by HIV in ScotlandIngrid YoungOffice of the Chief Scientific Adviser (CSO)PDF/14/02HW - MRC/CSO Social and Public Health Sciences Unit