Grant: Catalyst Grant: HIV/AIDS CBR Program - General Stream

Canada continues to see unacceptable rates of incident HIV, particularly among gay, bisexual and other men who have sex with men. A new strategy called PrEP (pre-exposure prophylaxis, the daily use of anti-HIV medication by those at high risk) holds great promise to help address this challenge. Our team is leading several studies on this topic, including a 'demonstration project' to gather real wold data about PrEP implementation. Importantly, since PrEP use remains uncommon in Canada, trial participants represent a 'first wave' of PrEP users in the country from whom much can be learned. However, when enrollees finish their 12-month participation in early 2016, they will do so in a context where PrEP cannot yet be universally accessed via public payers, creating a unique opportunity for reflection, dialogue and applied learning. We will harness this opportunity by seeking qualitative feedback from the participants and from PrEP users outside the trial in Toronto and Ottawa, and by soliciting recommendations from these "early adopters" about how PrEP should be delivered in future. Our objectives are to learn from the everyday lived experiences of PrEP users in order to: 1. Understand the motivations for initiating and continuing or discontinuing PrEP 2. Explicate the perceived impacts of PrEP use on sexual behaviour and sexual decision-making, 3. Explore the implications of these motivations and impacts on PrEP reimbursement policy 4. Determine what recommendations early adopters of PrEP have for how PrEP should be delivered to and supported 5. Conduct integrated knowledge translation and exchange (iKTE) activities with broader community stakeholders to aid in the interpretation of our findings. We will address these questions in a series of focus groups, followed by a 'World Café'-style iKTE activity. Our findings will directly inform how PrEP is provided in future PrEP implementation studies and what CBR is needed to address identified gaps.