PrEP acceptability and self-efficacy in men who have sex with men: the roles of identity, trust and knowledge

Gifford, AJ ORCID: https://orcid.org/0009-0002-8337-9951, Jaspal, R, Jones, BA ORCID: https://orcid.org/0000-0001-8872-5847 and McDermott, DT ORCID: https://orcid.org/0000-0001-7005-6446, 2025. PrEP acceptability and self-efficacy in men who have sex with men: the roles of identity, trust and knowledge. Psychology and Sexuality. ISSN 1941-9899

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Abstract

This study investigates psychosocial and structural predictors of pre-exposure prophylaxis (PrEP) acceptability and self-efficacy, addressing the need for targeted interventions to improve PrEP uptake in the United Kingdom (UK). A cross-sectional, online survey was conducted among UK-based men who have sex with men not currently using PrEP (N = 246). Participants completed validated measures assessing identity resilience, LGBTQ+ connectedness, outness, medical mistrust, perceptions of the NHS, and HIV knowledge. Structural equation modelling (SEM) was used to examine the relationships between these psychosocial factors and PrEP acceptability and self-efficacy, while controlling for age, previous sexually transmitted infection diagnosis, and condomless sex. The SEM demonstrated excellent model fit. PrEP acceptability was positively associated with LGBTQ+ connectedness and negatively associated with medical mistrust. Conversely, PrEP self-efficacy was positively associated with identity resilience, outness, NHS perceptions, and HIV knowledge. Findings show that the predictors of PrEP acceptability and self-efficacy are different, which should help inform interventions for promoting PrEP use . Enhancing LGBTQ+ connectedness and reducing medical mistrust may increase PrEP acceptability, while fostering identity resilience, outness, and positive perceptions of the NHS could strengthen PrEP self-efficacy. This study identifies distinct yet complementary predictors of PrEP acceptability and self-efficacy, emphasising the necessity for tailored interventions.

Item Type:	Journal article
Publication Title:	Psychology and Sexuality
Creators:	Gifford, A.J., Jaspal, R., Jones, B.A. and McDermott, D.T.
Publisher:	Routledge
Date:	25 November 2025
ISSN:	1941-9899
Identifiers:	Number Type 10.1080/19419899.2025.2592673 DOI 2526841 Other
Rights:	© 2025 the author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.
Divisions:	Schools > School of Social Sciences
Record created by:	Melissa Cornwell
Date Added:	19 Nov 2025 10:50
Last Modified:	10 Dec 2025 10:46
URI:	https://irep.ntu.ac.uk/id/eprint/54773

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