Intimacy, Condom Use, and Pre-Exposure Prophylaxis (PrEP) Acceptability among Men Who Have Sex with Men (MSM) in Primary Partnerships: a Comment on Gamarel and Golub

Excerpt

As evidence grows for the effectiveness of antiretroviral pre-exposure prophylaxis (PrEP) for HIV prevention [1‐6], complementary research on PrEP acceptability [7] and uptake [8‐13] has gained prominence. In the USA, PrEP acceptability research has largely focused on men who have sex with men (MSM) [14], given the sustained burden of HIV incidence in this group [15]. Although this work has identified many individual factors associated with willingness to use PrEP, emerging research has also examined PrEP acceptability in light of MSM partnership dynamics [16‐19]. Focusing on dyads is imperative: at least one third of HIV infections among US MSM occur within primary partnerships [20, 21], and relationship dynamics—including intimacy, commitment, and other interpersonal factors—demonstrably influence both HIV risk and protective behaviors [22, 23]. For example, prior studies report that many MSM in primary partnerships engage in condomless sex to express intimacy, and condom nonuse may be motivated by the desire to preserve these intimacy benefits [24‐27]. …