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Title: An exploration of PrEP-stigma and viewpoints on testing for HIV amongst men who have sex with men
Author: Hobbs, Richard
ISNI:       0000 0004 7973 0291
Awarding Body: Cardiff University
Current Institution: Cardiff University
Date of Award: 2019
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This thesis aimed to address gaps in the psychosocial aspects of Human Immunodeficiency Viruses (HIV) prevention ad testing literature as biomedical prevention methods have advanced. It is explored through three papers: a systematic review, an empirical study and a reflective critique. The systematic literature review utilised a narrative synthesis approach to explore and aggregate qualitative literature, which considered a newly reported phenomenon of Pre-Exposure Prophylaxis (PrEP) stigma as experienced by men who have sex with men taking PrEP. Eight studies were included in the final review. The studies were heterogeneous in the types of Men who have Sex with Men (MSM) they recruited and their methods. However, across the studies, it was demonstrated that PrEP-stigma was present at multiple levels. Five key themes identified were: 1. Stigma directly associated with PrEP; 2. Imposed stigma from others; 3. Internalised stigma; 4. Acts to mitigate stigma; 5. Sex-related stigma. The review concluded by arguing that PrEP-stigma can be imposed on the individual by others. PrEP-stigma can be internalised by PrEP users. There are various strategies that could be developed to overcome PrEP-stigma experienced by MSM who are PrEP users at the different levels within the system. The application of the findings to policy and clinical practice are considered alongside recommendations for further research. The empirical study utilised Q methodology to explore gay men's view on testing for HIV in Wales. Three distinct perspectives were identified: "testing PrEP and shame/stigma", "the psychological distress of testing and the search for certainty" and "HIV Testing a prosocial act and self-learning". The findings highlight that some aspects of HIV testing for gay men are consistent with previous research. The findings also describe how PrEP relates to the psychosocial context of HIV testing in Wales for gay men. That some PrEP users regularly test for HIV in order to gain long-term certainty over HIV status, but that this process can be stigmatising and shaming. The findings highlight the need for considerations of psychosocial context as HIV prevention methods develop. The implication of the findings for clinical practice and future research are considered. The third paper is a critique and reflection on the research undertaken and its process. This consists of: an extended discussion of the decisions made in the research process; plans of dissemination; strengths and weaknesses of the studies; specific implications for theory; clinical practice and policy and further research. Reflection and critique are also given on the thesis as a whole.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: BF Psychology ; H Social Sciences (General) ; RA Public aspects of medicine