A Cross-Sectional Survey of PrEP Awareness, Barriers and Facilitators for PrEP Uptake, and the Impact of Dosing Mechanisms on Willingness to Take PrEP Among MSM Indicated for PrEP Use in Philadelphia

This mixed-methods project will evaluate PrEP awareness and potential impact of new dosing strategies/modalities on PrEP uptake among men who have sex with men (MSM)-the target group at highest risk for infection and at highest priority for PrEP use based on high risk sexual behaviors (condomless anal intercourse). The proposed project utilizes both qualitative analysis of focus group data from MSM study participants, as well as quantitative analysis of results from a survey informed by results of the qualitative phase of our project. It should be noted that while the investigators will target a racially diverse MSM study population, participation in our study may include MSM who also inject drugs (MSM-PWID) who express interest in study participation.

The investigators propose a one and one-half year mixed-methods study to evaluate self-reported sexual risk, knowledge and barriers/facilitators of PrEP use, and preferences of oral, injectable, and implantable PrEP treatment modalities-as a function of race and age, and experience with intersectional discrimination. The first qualitative phase of our study would be conducted over the first eight months, followed by a quantitative phase that will collect data via online cross-sectional survey over the remaining ten months.

Recruitment for both qualitative and quantitative parts of our project will occur through events sponsored by the Philly Ballroom Community, freeHIVTest.Net, GALAEI and COLOURS (CBOs), and Drexel's HIV Clinical Center, the Partnership Comprehensive Care Practice. For our quantitative survey, the investigators plan to enhance our recruitment using online social media sites that especially target BMSM and HLMSM, and Google Words-the investigators will display links to our study that will enable recruitment.

For qualitative work, the investigators plan to conduct six focus groups of 5 MSM each (total = 30 participants), each restricted by race and age (Black, White, or Hispanic/Latino (either Black or White) and age (18-39 yrs. of age and > 40 yrs. of age). Four to six focus groups are usually recommended to reach saturation. Given probable cultural and age-specific differences of PrEP awareness and knowledge, as well as barriers or facilitators, and preference for specific treatment modalities, the investigators plan to restrict group participation by race and age as outlined above.

Data collected from the 30 focus group participants will be analyzed using standard qualitative analytic approaches (Months 7-8). Drexel University's Dornsife School of Public Health have available a wide range of qualitative data analysis software and strategies for more sophisticated coding, retrieval, and concept development of the information collected in the focus groups. The investigators will utilize standard qualitative techniques, including inductive code identification and development and associated documentation through marginal remarks and memos. Inductive coding ("open coding") involves a data-based approach to the identification of key themes (codes). This approach encourages a conceptualization and organizational framework of the data from a grounded perspective. NVivo, a system for the management, interpretation and analysis of qualitative data, will be used in this process. Results from the qualitative phase of our project will be used to inform/add to the content of our study instrument to collect data during the second, quantitative phase of our project. For the quantitative, cross-sectional survey, the investigators plan to enroll equal numbers of White, Black, and Hispanic/Latino MSM (100 members per racial/ethnic group, for a total of 300 participants).