Let\u27s Be a Person to Person and Have a Genuine Conversation : Comparing Perspectives on PrEP and Sexual Health Communication Between Black Sexual Minority Men and Healthcare Providers

Patient-provider communication is a key factor affecting HIV pre-exposure prophylaxis (PrEP) awareness and access among Black sexual minority men (SMM). Optimizing patient-provider communication requires a deeper understanding of communication dynamics. In this study, we investigated the perspectives of both HIV-negative/status-unknown Black SMM and practicing community healthcare providers regarding patient-provider communication about PrEP and sexual health. We conducted eleven semi-structured qualitative focus groups (six with Black SMM; five with providers) in the Northeastern USA and thematically analyzed transcripts. A total of 36 Black SMM and 27 providers participated in the focus groups. Our analysis revealed points of alignment and divergence in the two groups\u27 perspectives related to patient-provider communication. Points of alignment included: (1) the importance ascribed to maximizing patients\u27 comfort and (2) belief in patients\u27 right to non-discriminatory healthcare. Points of divergence included: (1) Black SMM\u27s preference for sexual privacy versus providers\u27 preference that patients share sexual information, (2) Black SMM\u27s perception that providers have an ethical responsibility to initiate conversations about PrEP with patients versus providers\u27 perception of such conversations as being optional, and (3) Black SMM\u27s preference for personalized sexual health conversations versus providers\u27 preference for standardized conversations. Findings underscore a need for providers to offer more patient-centered sexual healthcare to Black SMM, which should entail routinely presenting all prevention options available-including PrEP-and inviting open dialogue about sex, while also respecting patients\u27 preferences for privacy about their sexuality. This approach could increase PrEP access and improve equity in the US healthcare system