American gay men who have chosen to take pre-exposure prophylaxis (PrEP) are aware of their own risk of being exposed to HIV and see PrEP as providing ‘an extra layer of protection’ on top of their efforts to use condoms, some or all of the time. The use of PrEP can help reduce anxiety and provide greater ‘peace of mind’, men reported in in-depth interviews.

The study also sheds light on the motivations of men who stopped taking PrEP or who chose not to take it at all. Most frequently this was because their sexual relationships or behaviour had changed, but concern about potential side-effects also deterred a number of men.

The findings were presented to the 9th International Conference on HIV Treatment and Prevention Adherence in Miami earlier this week. Hailey Gilmore and colleagues interviewed 87 American men who have sex with men who were enrolled in iPrEx OLE – a programme which offered men who had participated in a clinical trial of PrEP the possibility to take, or continue to take, PrEP after the randomised study had ended. Whereas the effectiveness of PrEP had previously been unknown, by this stage men had learnt that it could help prevent HIV infection.

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