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Publication Profiles

“Do I want PrEP or do I want a roof?”: Social determinants of health and HIV prevention in the southern United States

Citation

Harrison SE, Paton M, Muessig KE, Vecchio AC, Hanson LA, Hightow-Weidman LB. “Do I want PrEP or do I want a roof?”: Social determinants of health and HIV prevention in the southern United States. AIDS Care. 2022;34(11):1435-1442. doi:10.1080/09540121.2022.2029816

Implementation stage:

Pre-Implementation

Implementation outcomes reported:

Not applicable

Continuum target addressed:

PrEP initiation, Linkage to preventative care

Geography:

South Carolina

Study Participant Classification:

Providers, Recipients of care

Plain Language Objectives

The researchers wanted to understand how housing, food, transportation, health-care access, and education affected HIV prevention for young sexual and gender minority people in rural North and South Carolina.

Plain Language Abstract

Increasing use of pre-exposure prophylaxis, or PrEP, among young men who have sex with men and transgender women is an important part of ending the HIV epidemic. In rural communities, however, immediate needs and limited services may make HIV prevention difficult. Researchers conducted 14 interviews with key stakeholders and three focus groups involving 23 young men who have sex with men or transgender women in rural North and South Carolina. Participants described economic barriers, including unstable housing and food insecurity; neighborhood barriers, especially inadequate transportation; health-system problems such as shortages of providers; and educational gaps, including limited access to comprehensive and inclusive sexual education. These themes show why a person may have to prioritize shelter or food over PrEP and why simply making medication available may be insufficient. The authors emphasized understanding the rural Southern social environment and building local, community-based partnerships when planning prevention programs. This qualitative study did not measure how common each barrier was or test a specific intervention. Its findings represent the experiences and perspectives of the people who participated.

Key Takeaways

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