HIV understanding, experiences and perceptions of HIV-positive men who have sex with men in Amazonian Peru: A qualitative study.

• DOI: 10.21203/rs.3.rs-15919/v1
• Publication Date: 2020-03-03T21:56:15Z
• Authors: Jasmine Tattsbridge; Connie Wiskin; Gilles De Wildt; Anna Clavé Llavall; César Ramal-Asayag
• Keywords: Adult; Male; Health Knowledge, Attitudes, Practice; Health Personnel; Social Stigma; HIV Infections; Sexual and Gender Minorities; 03 medical and health sciences; 0302 clinical medicine; Peru; Humans; 10. No inequality; Qualitative Research; HIV; Focus Groups; Middle Aged; Antiretroviral therapy; 3. Good health; Men who have sex with men; Anti-Retroviral Agents; Public aspects of medicine; RA1-1270; Qualitative; Research Article

Abstract Background HIV-related incidence and mortality is increasing across Peru, with highest mortality rates recorded in Amazonian Loreto. This epidemic is concentrated in MSM, a population with 14% HIV treatment adherence despite free national provision. This study investigates barriers and facilitators to following healthcare advice through experiences and perceptions of HIV-positive MSM and healthcare professionals in Loreto. Methods Twenty qualitative interviews with HIV-positive MSM and one focus group with HIV-specialist healthcare professionals were conducted in Loreto, January-February 2019. Thematic content analysis was used. Results A culture of isolation and discrimination was identified, propagated by poor public knowledge surrounding HIV transmission and treatment. Employment potential was hampered and 7/20 patients had suicidal thoughts post-diagnosis. Barriers to care included: shame, depression, travel cost/times, a preference for traditional plant-based medicine and side-effects of ART. Facilitators included: education, family and clinic support, disease acceptance and lifestyle changes.Conclusion More targeted community education and workplace discrimination investigations are recommended.