We Have a Stronger Survival Mode- Exploring Knowledge Gaps and the Culturally Sensitive Messaging of PrEP Among Latino Men Who Have Sex with Men and Latina Transgender Women in Los Angeles, CA

Background and Purpose: Understanding the barriers and facilitators to accessing the most up-to-date HIV prevention information is important for reducing racial and economic inequality. For instance, pre-exposure prophylaxis (PrEP) is a biomedical intervention that can reduce the sexual risk of getting HIV by 90% through sexual contact; however, several studies have documented that awareness and utilization of PrEP is low among racial and ethnic minority men who have sex with men and transgender women. Despite such advances in HIV prevention information and strategies, Latino men who have sex with men (LMSM) and Latina transgender women (LTGW) face ongoing challenges in accessing the most up-to-date prevention information and continue to be disproportionately impacted by HIV. We explored knowledge gaps and culturally sensitive messaging about PrEP among HIV-negative LMSM and LTGW in Los Angeles.

Methods:We recruited participants from a Latinx LGBT community-based organization. We conducted nine focus groups (n = 91 participants) with 52 LMSM and 39 LTGW. We used a rapid assessment process to create narrative reports that we analyzed using thematic analysis. Key quotes were transcribed verbatim; they were reviewed by the team, then uploaded to Dedoose to identify themes across sites and between groups. 

Results: The following three themes emerged from our analysis of the focus group discussions: information gaps regarding PrEP remain; people who have knowledge about PrEP often served as its champion; understanding Latinx subgroup differences and highlighting positive aspects of culture (e.g. Latinx people as hardworking and committed to their families) could help improve the uptake and continued utilization of PrEP. Only LMSM raised concerns regarding how PrEP could impact condom use. Some issues were more pronounced among LTGW (e.g., more limited access to PrEP), while others were unique to LTGW (e.g., drug interactions between PrEP and hormones).

Conclusions and Implications: LMSM and LTGW bear an especially heavy HIV burden and face many obstacles in accessing information about effective prevention methods. To improve the uptake and continued utilization of PrEP or other important resources, the meaningful participation of LMSM and LTGW in the design and implementation of research, programs, and policies will prove critical to ensuring these efforts address aspects of Latinx cultures that can act as barriers to PrEP as well as identify sensitive framing of other cultural norms as potential sources of resilience.