Amsterdam 2015
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| Abstract #2186 - PrEP | ||||
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Session: 50.6: PrEP (Symposium) on Friday @ 11.00-12.30 in C103 Chaired by John de Wit, Veronica Noseda Authors: Presenting Author: Mr Xavier Mabire - Université Lumière Lyon 2, Groupe de Recherche en Psychologie Sociale (EA 4163 GRePS), France |
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| Additional Authors: | ||||
| Aim: ANRS-Ipergay is a biomedical trial investigating the efficacy of an "on demand" HIV pre-exposure prophylaxis (PrEP). This randomized, double-blind, placebo-controlled trial, focuses on men who have sex with men. We conducted a social psychology study to examine the subjective experience of participants, this communication presents the main results and highlight the incentives for and obstacles to using the on demand prophylaxis. | ||||
| Method / Issue: Individual in-depth interviews were held, repeated once during follow-up. The present study is based on data from 32 interviews taken from 16 subjects between March 2012 and July 2014. Median age of interviewees was 41 (range 26-54). A textual analysis was performed using Iramuteq, an open-source automated statistical text analysis software. This software classifies words into clusters: co-occurrent words are associated with a cluster or another depending on their proximity with the cluster (calculated with khi2 tests). Clusters are differentiated comparing the specificity of their contents. Beyond the cluster analysis, we performed an additional analysis focusing on the thematic of risk-taking. Baseline and follow-up interviews were analysed separately in order to compare the contents and highlight changes in discourses. | ||||
| Results / Comments: The retention rate of this analysis is high, with 92% of the corpus classified by the software. Three main clusters emerged from the automated analysis revealing the general discourse organisation. Firstly, the behavioural components of the trial: sexual practices, relationship with partner (17.6% of the corpus). This gives us an overview of the preventing and sexual practices before and after entering the trial. Secondly, the pragmatic elements: the trial’s overall organisation, taking tablets (10.4% of the corpus), that appears to act as an incentive (especially repeated HIV/STIs-testing and pill uptake). Thirdly, the reflexive elements: motivations, benefits, socio-political implications of the trial (32.1% of the corpus). Not only we can find positive factors and motivators, but this cluster indicate that fear of stigma is common in the participants’ discourse. The subsequent analysis on risk-taking compared the first and second interview and showed that even if this topic came up in both interviews, a different discourse structure appeared. This, suggesting a modification related to experience, as well as contextual effects. In the first interview, risk-taking acted as a motivation to enter the trial (interviewees reported a recent relapse concerning prevention, more frequent risk-taking), while in the second, it constituted an exposure factor better managed by participants (interviewees declared using more prevention options offered by the trial such as HIV testing, counselling, pair-support, pills). | ||||
| Discussion: These results illustrate the various aspects of experience with PrEP, and more generally, participation in the ANRS-Ipergay trial. Participation is determined not only by the tablet intake, but also by the perception of an overall strategy for risk-prevention and promotion of sexual health. Effects of context, linked to the grounding of this trial within the gay community, influence the participants’ experience. Our results highlight the positive and negative aspects of the implementation of an on-demand PrEP offer within the context of Ipergay, and by extension, the characteristics of an effective PrEP offer for all concerned populations. | ||||
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