Gay, bisexual and other men who have sex with men: intersectionality and the PrEP care continuum

OBJECTIVE: To analyze the impacts of intersecting systems of oppression in the continuum of pre-exposure prophylaxis (PCPrEP) care among gay, bisexual, and other men who have sex with men (aGBMSM) and how they are identified and treated by health professionals (HCPs), aiming at sexual health care and HIV prevention. METHODS: Qualitative research study integrated into a cohort study with aGBMSM and transgender and transvestite women (aMTrT) using PrEP. Data produced in the city of Sao Paulo were analyzed, integrating 16 interviews with aGBMSM and eight with health workers. The theoretical methodological framework was guided by the interactive categorization of thematic analysis with an intersectional framework. RESULTS: Knowledge about PrEP among aGBMSM is affected by the negative effects of systems of oppression, especially among black adolescents who acquire knowledge in a less technical way when compared to whites. Most professionals recognize oppression and its consequences, and give prominence to racism, but few articulate the different social markers that increase barriers to the success of CCPrEP. CONCLUSIONS: Social oppressions impact the success of PrEP in different ways. Health professionals are central to mitigating and preventing the spread of these negative experiences within the health service and in accessing, using and adhering to PrEP.