PrEP: What does it mean for MSM, our community, and those who work with them? Justin Harbottle Programme Officer: Quality and Engagement, Terrence Higgins Trust, London 1. Individuals Voice of the Participants: https://vimeo.com/ The PROUD Study (documentary): https://vimeo.com/ Rethinking at-risk? Poor condom usage Ambivalence about HIV, Socio-economic education, poor self-esteem, drugs and alcohol, poor mental health. Ambivalence about HIV, Socio-economic education, poor self-esteem, drugs and alcohol, poor mental health. Rethinking at-risk? Poor PrEP adherance Rethinking at-risk? PrEP Activism PrEP in practice: disclosure HIV Status Positive Undetectable Poz + Other Negative Neg + PrEP Neg + Other Other Unsure Do not care Ask me PrEP in practice: disclosure Hornet KYS: Know Your Status 2. US backlash 11 2. US backlash 2. The Community Critics warned that The Pill would spawn generations of loose, immoral women; what it spawned was generations of empowered women who are better equipped to make rational choices about their lives 2. Community backlash? Community statement: September 2013 & Nov ,491 signatories 2. Community backlash 2. The Community PrEP Facts Stop HIV. PreP Now 3. Health Promotion 3. Health Promotion for MSM Penetrative anal sex with a condom Oral sex without a condom? (probably) STI screens? (at a push) Safer Sex = Partner numbers duration /settings group/drug use? 3. Health Promotion Does PrEP change how we think about PEP? 3. Health Promotion What are the goals or outcomes with someone successfully using PrEP? Improve wider health determinants? (chems, sexual compulsion, mental health?) Seasons of risk? Move back to condoms? Other harm reduction? Thank you Facebook: Stop HIV. PrEP Now.