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AIDS and Behavior
Published in: AIDS and Behavior 7/2016

01-07-2016 | Original Paper

Sexual Behavior, Risk Compensation, and HIV Prevention Strategies Among Participants in the San Francisco PrEP Demonstration Project: A Qualitative Analysis of Counseling Notes

Authors: J. Carlo Hojilla, Kimberly A. Koester, Stephanie E. Cohen, Susan Buchbinder, Deawodi Ladzekpo, Tim Matheson, Albert Y. Liu

Published in: AIDS and Behavior | Issue 7/2016

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Abstract

Pre-exposure prophylaxis (PrEP) is a viable HIV prevention strategy but risk compensation could undermine potential benefits. There are limited data that examine this phenomenon outside of clinical trials. We conducted a qualitative analysis of counseling notes from the San Francisco site of the US PrEP demonstration project to assess how men who have sex with men used PrEP as a prevention strategy and its impact on their sexual practices. Four major themes emerged from our analysis of 130 distinct notes associated with 26 participants. Prevention strategy decision-making was dynamic, often influenced by the context and perceived risk of a sexual encounter. Counselors noted that participants used PrEP in conjunction with other health promotion strategies like condoms, asking about HIV status of their sex partners, and seroadaptation. With few exceptions, existing risk reduction strategies were not abandoned upon initiation of PrEP. Risk-taking behavior was ‘seasonal’ and fluctuations were influenced by various personal, psychosocial, and health-related factors. PrEP also helped relieve anxiety regarding sex and HIV, particularly among serodiscordant partners. Understanding sexual decision-making and how PrEP is incorporated into existing prevention strategies can help inform future PrEP implementation efforts.
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Metadata
Title
Sexual Behavior, Risk Compensation, and HIV Prevention Strategies Among Participants in the San Francisco PrEP Demonstration Project: A Qualitative Analysis of Counseling Notes
Authors
J. Carlo Hojilla
Kimberly A. Koester
Stephanie E. Cohen
Susan Buchbinder
Deawodi Ladzekpo
Tim Matheson
Albert Y. Liu
Publication date
01-07-2016
Publisher
Springer US
Published in
AIDS and Behavior / Issue 7/2016
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-015-1055-5

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