Transforming the sexual health landscape through PrEP: a qualitative content analysis of experiences among MSM in Sweden

Oral pre-exposure prophylaxis (PrEP) is a highly effective and safe way to prevent HIV acquisition among men who have sex with men (MSM). PrEP became available to MSM in Sweden in 2018, but there have been challenges in its accessibility. The aim of this study was to gain an improved understanding of the lived experience of MSM enrolled in a PrEP program in Sweden. Data were collected through in-depth interviews with 16 MSM enrolled in the Uppsala PrEP program, which was the first PrEP program in Sweden. After being transcribed verbatim, data were analyzed using qualitative content analysis with an inductive approach to explore both the manifest and latent meanings of the interviews. The analysis resulted in an overarching theme: <i>Transforming the sexual health landscape through PrEP,</i> based on three descriptive sub-themes representing the perceptions and experiences among the participants: <i>Constructing the "deserving" PrEP user, Being in the process of re-defining HIV,</i> and <i>Becoming a new sexual being.</i> The results suggest that while several benefits, such as reduced HIV anxiety and sexual freedom, are experienced by PrEP users, continued HIV worry, risks of bacterial STIs and negative experiences of stigma and control are challenges that need to be addressed further.