THPE271 - Poster Exhibition
“Prevention is more than just a method”: ARV-based prevention from the attitudes and behaviors of MSM and transwomen in light of the current conditions of public health services in Peru
E.A. Núnez-Curto Sifuentes, X. Salazar Lostaunau, C. Cáceres Palacios
Universidad Peruana Cayetano Heredia, Unidad de Salud, Sexualidad y Desarrollo Humano, Lima, Peru
Prophylaxis (PrEP) and Early Treatment for Prevention (ETfP) are new strategies for HIV
prevention, based on the use of antiretrovirals (ARV). They can improve
prevention options and synergize with condom use in combination
prevention programmes. In light of the
publication of the 2013 WHO integrated guidelines for the use of ARV, this
study indentifies and analyzes differential perceptions, barriers and needs for
AVR-based prevention in the current conditions of the public
health system and the services offered to key populations in Peru.
conducted a qualitative study in Lima and Callao with potential users and stakeholders. Here we report on
8 in-depth interviews and 4 focus groups
with potential users (MSM and transgender
women -TGW)), 4 in-depth interviews with community leaders and 4 in-depth
interviews with stakeholders.
Results: Participants have a fairly consistent knowledge about HIV,
where condom use is still the epitome of prevention, although its use is still inconsistent.
ETfP is almost absent in this population. Some knowledge of PrEP
comes mainly from the iPrEX clinical trial. The lack of
information, misconceptions and confusion reflect limited public discussion on new HIV
prevention technologies in Peru. Worries about effectiveness, daily
adherence, side effects and the generation of resistance
are more common for PrEP than for ETfP. On an operational level, participants consider
the need of well-trained physicians, other health
providers, and peer counselors as part of a suitable program. Concerning
potential implementation, while gay and other MSM demand more information on
effectiveness and side effects, TGW consider that HIV prevention cannot be
separated from expanded, improved health services for them.
considered prevention as an individual responsibility, while their own health
is their priority. It is unclear to what extent this varies in serodiscordant
couples involving transwomen and MSM. Considering perceptions on effectiveness,
side effects and adherence, implementation of ETfP is viewed more favorably than
that of PrEP. Findings demonstrate the need for public discussion on these
matters and straightforward information channels
on ARV-based prevention targeting this key population.
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