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BMC Public Health
Published in: BMC Public Health 1/2023

Open Access 01-12-2023 | Human Immunodeficiency Virus | Research

Insights into barriers and facilitators in PrEP uptake and use among migrant men and transwomen who have sex with men in Belgium

Authors: Ella Van Landeghem, Stef Dielen, Aline Semaan, Anke Rotsaert, Jef Vanhamel, Caroline Masquillier, Edwin Wouters, Kristien Wouters, Bea Vuylsteke, Thijs Reyniers, Christiana Nöstlinger

Published in: BMC Public Health | Issue 1/2023

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Abstract

Background

PrEP uptake is low among non-Belgian men and transwomen who have sex with men, although the HIV epidemic among men who have sex with men in Belgium is diversifying in terms of nationalities and ethnicity. We lack an in-depth understanding of this gap.

Methods

We conducted a qualitative study using a grounded theory approach. The data consists of key informants interviews and in-depth interviews with migrant men or transwomen who have sex with men.

Results

We identified four underlying determinants which shape our participants’ experiences and contextualize the barriers to PrEP use. These include (1) the intersectional identities of being migrant and men and transwomen who have sex with men, (2) migration related stressors, (3) mental health and (4) socio-economic vulnerability. Identified barriers include: the accessibility of services; availability of information, social resources and providers’ attitudes. These barriers influence PrEP acceptance and mediated by individual agency this influences their PrEP uptake.

Conclusion

An interplay of several underlying determinants and barriers impacts on PrEP uptake among migrant men and transwomen who have sex with men, illustrating a social gradient in access to PrEP. We need equitable access to the full spectrum of HIV prevention and care for all priority populations, including undocumented migrants. We recommend social and structural conditions that foster exercising these rights, including adapting PrEP service delivery, mental health and social support.
Footnotes
1
We use the “migrant and ethnic minorities” as a term to describe anyone who was not born in Belgium or Western-Europe. We are aware that this is a very diverse population and can include (non-exhaustive list): asylum-seekers, refugees, documented migrant workers and people with irregular status, as well as people with different lengths of residence/stay in the country.
 
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Metadata
Title
Insights into barriers and facilitators in PrEP uptake and use among migrant men and transwomen who have sex with men in Belgium
Authors
Ella Van Landeghem
Stef Dielen
Aline Semaan
Anke Rotsaert
Jef Vanhamel
Caroline Masquillier
Edwin Wouters
Kristien Wouters
Bea Vuylsteke
Thijs Reyniers
Christiana Nöstlinger
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2023
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-023-15540-y

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