A new study led by a UTSA researcher examines the social perceptions of Pre-Exposure Prophylaxis (PrEP), a medication to prevent HIV, among gay and bisexual men in Texas.
The U.S. Food and Drug Administration (FDA) approved the use of PrEP in 2012. While evidence suggests that the medication is effective in preventing the spread of HIV, recent data show that only 9 percent of PrEP-eligible gay or bisexual men use the drug. The statistic is even lower for men of color.
Over a six-month period, UTSA assistant professor Phillip Schnarrs worked with education, health care and nonprofit partners to survey more than 100 gay and bisexual men from the White, Latino and African-American communities about their perceptions of PrEP.
Participants were asked 16 open-ended questions assessing experiential attitudes, instrumental attitudes, perceived behavioral control and perceived social norms.
They were also asked to list individuals or groups who would approve and not approve of them using PrEP. In addition, participants were also asked their age, relationship status, annual income, educational attainment, sexual orientation, gender, HIV status and whether they had ever been prescribed PrEP in the past.
When participants were asked who would approve or disapprove of their PrEP use, White respondents reported a broader array of individuals who would approve compared to African-American and Latino men.
Schnarrs said, most striking is the finding on family approval. While African-American and White men indicated their families would approve of their PrEP use, no Latino participants reported this about family.
In fact, nearly a quarter (24%) of Latino participants indicated their families would disapprove of their PrEP use. This may be an additional barrier to PrEP uptake among this group in Texas. Schnarrs said, the finding about family is particularly important for San Antonio because of Cluster 51, a group of related HIV cases involving Latino men.
"If we want to increase awareness of and access to PrEP, we must understand how the drug is perceived across racial and ethnic groups," said Schnarrs. "This research will serve as a launch point to change perceptions associated with PrEP so we can get it into the hands of the people who need it most."
In addition to revealing racial disparities in PrEP perceptions, the research suggested that access to PrEP is limited for racial and ethnic minorities. According to the research, Schnarrs believes minorities may lack access to the medication due to limited knowledge of PrEP, financial barriers, language barriers and/or lack of insurance coverage. Schnarrs added that this research collaboration will be ongoing.
Schnarrs collaborated on the study with researchers from the UTSA Department of Sociology, UTSA Institute for Health Disparities Research, South Texas Consortium for HIV & STI Research, University of Texas School of Public Health, San Antonio AIDS Foundation, University of California, San Francisco Department of Epidemiology, Center for HIV Educational Studies and Training in New York, Department of Psychology at Hunter College in New York and Austin PrEP Access Project. The study was funded by a UTSA College of Education and Human Development Faculty Research Grant.
Schnarrs' research has largely focused on health promotion and addressing health issues facing LGBTQ+ populations. He also researches how the LGBTQ+ population copes with discrimination and stigmas.
Last year, Schnarrs was selected as a fellow in the Interdisciplinary Research Leaders Program, led by the University of Minnesota with support from the Robert Wood Johnson Foundation. During the three-year program, Schnarrs along with Amy Stone, associate professor of sociology and anthropology at Trinity University, and Robert Salcido from Pride Center San Antonio and Equality Texas, will study resilience in the LGBTQ+ populations in San Antonio and South Texas.
The UTSA professor is involved with several groups focused on uplifting LGBTQ+ individuals. In 2013, Schnarrs co-founded UTSA's LGBTQ Faculty and Staff Association, to provide a social support system for the campus community. In 2017, he became a board member of OUT Youth, a statewide advocacy organization in Texas focused on LGBTQ+ youth and young adults.
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