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Facilitators and barriers of Pre-exposure Prophylaxis (PrEP) uptake have been established in prior studies; however, most of these studies comprise samples of MSM from metropolitan cities and hypothetical PrEP use. There is a dearth of literature on the uptake factors among rural U.S. MSM who are prescribed PrEP. Thirty-four rural Midwestern MSM who currently take PrEP participated in semi-structured telephone interviews about their barriers and facilitators to their PrEP use. Interviews were analyzed using an inductive thematic analysis approach. There were four barriers: (1) lack of rural dissemination of PrEP information, (2) concern about side and adverse effects of using PrEP, (3) cost of PrEP uptake and engagement, and (4) lack of access to PrEP care and PrEP care quality. Individual and social facilitators that participants utilized to overcome these barriers are discussed. Findings elevate the importance of multilevel interventions that address PrEP adoption from a patient, provider, and healthcare system perspective. [ABSTRACT FROM AUTHOR]

Bisexual individuals have disproportionately higher rates of physical and mental health concerns compared to both heterosexual and gay/lesbian individuals. Few studies have examined diverse bisexual-identified men's perceived health concerns for themselves and other bisexual men or their experiences in healthcare settings. This qualitative study explored health and healthcare experiences among cisgender and transgender bisexual men, most of whom were also men of color. Data were collected through semi-structured interviews. Participants included 31 self-identified bisexual men from the Chicago area. Participants were asked questions surrounding bisexual men's health and healthcare experiences in general and their personal experiences, drawing connections between intersecting bisexual and racial/ethnic identities. Interview transcripts were analyzed using thematic analysis. Participants reported sexual health and mental health as the top health concerns for bisexual men. Participants viewed their bisexual identity as a motivator for seeking healthcare services and adopting safer sex practices. Mental health challenges faced by respondents were connected to bisexual stereotypes and fear of disclosing bisexual and transgender identities. Furthermore, perceptions of masculinity amongst bisexual men of color were particularly salient in connecting to their mental health experiences. The intersection of participants' transgender and bisexual identities impacted their healthcare experiences in general healthcare settings, with many participants reporting a lack of cultural competence and provider knowledge concerning their identities. LGBTQ Federally Qualified Health Centers, however, were described as providing compassionate care. Our findings suggest the need for more interventions that account for bisexual men's intersecting identities. Furthermore, increased provider training is necessary for providing affirmative care to bisexual men. [ABSTRACT FROM AUTHOR]

Objective. To examine knowledge of Zika transmission and risk perception and to assess variability by condom use in a probability sample of sexually-active adults in the United States. Methods. Data for this study came from the 2016 wave of the National Survey of Sexual Health and Behavior, a nationally representative probability sample of adults in the United States. Data were collected in November 2016 via a cross-sectional Internet-based survey administered to members of a Knowledge Panel, an address-based random sample service managed by GfK. A weighted subsample (n = 1 713) of sexually active adults, 18 - 50 years of age, was included in analyses. Results. More than 90% of men and women reported low or no perceived risk of Zika. Most participants identified mosquito bite as a route of transmission, while significantly fewer identified sexual intercourse (≈ 40%) and vertical (29% men, 41% women) transmission routes. Conclusion. Sexually-active adults in the United States, especially young men, lack awareness of sexual and vertical transmission of Zika Virus. Given the likely endemic nature of Zika, this low-risk perception is an important prevention challenge. Zika prevention messaging should address lesser known transmission routes, emphasize male education, and promote correct and consistent condom use. [ABSTRACT FROM AUTHOR]