A social curse: exploring gay, bisexual, and men who have sex with men’s attitudes to HIV pre-exposure prophylaxis usage

Griffiths, D., 2023. A social curse: exploring gay, bisexual, and men who have sex with men’s attitudes to HIV pre-exposure prophylaxis usage. PhD, Nottingham Trent University.

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Pre-exposure Prophylaxis (PrEP) is a novel drug that prevents HIV-negative individuals from contracting HIV (Human Immunodeficiency Virus). It is primarily used by gay men, bisexual men, and men who have sex with men (gbMSM). However, stigmatised associations between gbMSM, HIV, and PrEP may hinder PrEP uptake. This thesis makes a novel contribution to the literature by using the Social Identity Approach to Health (SIAH; Haslam et al., 2018) as a theoretical lens through which to explore group-based processes potentially underpinning gbMSM attitudes to PrEP, and the possible effects of these processes on gbMSM health.

A mixed-methods design was used. Using semi-structured interviews, Study 1 qualitatively explored gbMSM’s (N =21) perceptions of PrEP via Theoretically Guided Reflexive Thematic Analysis (Braun & Clarke, 2021). As well as providing rich accounts of the intragroup, intergroup and broader societal processes involved in shaping participants’ attitudes to PrEP, Study 1’s findings informed the measures used in Study 2. This was a quantitative online survey study which cross-sectionally (N=203) and longitudinally (N=128) explored gbMSM attitudes to PrEP. Study 2’s findings indicated that group processes may help explain gbMSM attitudes to PrEP, in addition to shedding light on the SIAH-related variables that mediate the relationship between gbMSM group identification and wellbeing.

Across these studies, gbMSM reported sexual risk-taking as being normative (i.e., a Social Curse), yet gbMSM identification also predicted positive PrEP attitudes and wellbeing. Findings also indicated that gbMSM often anticipated stigma and discrimination from healthcare professionals, frequently using meta-perceptions to appraise how professionals may perceive gbMSM and PrEP users.

This thesis contributes to theoretical understandings of how group-based processes impact on health, discusses the need for future research which examines barriers to PrEP uptake in more depth, and concludes with practical recommendations aimed at addressing how to strategically harness gbMSM identification to improve attitudes to PrEP.

Item Type: Thesis
Creators: Griffiths, D.
Wakefield, J.Thesis supervisorPSY3WAKEFJorcid.org/0000-0001-9155-9683
Kellezi, B.Thesis supervisorPSY3KELLEBorcid.org/0000-0003-4825-3624
Bowe, M.Thesis supervisorPSY3BOWEMorcid.org/0000-0002-0491-1472
Date: October 2023
Rights: This work is the intellectual property of the author. You may copy up to 5% of this work for private study, or personal, non-commercial research. Any re-use of the information contained within this document should be fully referenced, quoting the author, title, university, degree level and pagination. Queries or requests for any other use, or if a more substantial copy is required, should be directed in the owner(s) of the Intellectual Property Rights.
Divisions: Schools > School of Social Sciences
Record created by: Laura Ward
Date Added: 15 Apr 2024 09:48
Last Modified: 15 Apr 2024 09:48
URI: https://irep.ntu.ac.uk/id/eprint/51248

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