PrEP Focus Group Moderator Guide

Form Approved

OMB No. 0920-New

Expiration Date: XX/XX/XXXX

Understanding Decisions and Barriers about PrEP Use and Uptake Among Men Who Have Sex With Men

Attachment # 3d

Focus Group Moderator Guide

Public reporting burden of this collection of information is estimated to average 60 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; Attn: OMB-PRA (0920-New)

Understanding PrEP Refusers and Unsuccessful Initiators

Focus Group Moderator’s Guide

• Five participants rescreened and eligible for this group

• Completed Consent

FOCUS GROUP ID: ________

INDIVIDUAL GROUP MEMBER IDs: /________/________/________/________/________/

MODERATOR INITIALS (XXX): _______

DATE: _________ START TIME: __:__AM/PM

Introduction and Focus Group Purpose

Welcome and thank you for agreeing to participate in this study. My name is ________ and I am part of a research team working to understand different perspectives on PrEP, or pre-exposure prophylaxis, which prevents HIV infection. During our discussion we will be talking about sex, HIV, PrEP, and related topics. We want to hear about what you know, think, and believe. There are no right or wrong answers to the questions I’m going to ask. I want to hear, in your own words, your thoughts, experiences and opinions about the topics we’ll be discussing. Please remember that you can choose not to respond to a question at any time and that your participation in this study is completely voluntary.

First, I would like to cover the ground rules for this discussion:

• You have been asked here to offer your views and opinions.

  • There are no right or wrong answers to the questions I will ask.

  • We know that each of you might have different views about today's topic and it's ok to disagree with others. If you hear opinions that you do not agree with, we ask that you respectfully listen before you share your own opinion.

• Everyone’s input is important; I may call on you if you are being quiet.

• The study team will keep your answers and information secure and private, so feel free to speak your mind.

• We also ask that you not share comments you hear today with anyone outside this room. You should know that there is the possibility that a focus group participant may not honor this request.

• Please avoid side conversations.

• Let one person speak at a time.

• I may need to cut a discussion short to get through all of my questions.

• Please turn off your cell phones

Does anyone have any questions before we begin? <ANSWER ANY QUESTIONS THAT COME UP.>

If there are no more questions, I am going to start recording now. [Turn on audio recorders]

Warm Up

Let’s begin by finding out a little bit about each of you. Please tell me your nickname, which is the name you want to use today, and how long have you lived in the area.

[Go around the table until everyone has introduced themselves]

Thank you. Now we will get into the discussion.

Section 1: Knowledge and decision-making about PrEP, and sources of knowledge

1. Let’s talk about PrEP. What do you know about PrEP and what is your gut feeling about PrEP?

Probe: What are some positives and some negatives about PrEP?

Probe: Why is PrEP not right for you now?

2. What do your friends say about PrEP? How much did you listen to their opinion when you made your decision (not to take/to stop taking/to not fill the script) about PrEP?

3. What do your medical provider and other healthcare staff, like HIV test counselors, say about PrEP? How much did they influence your decision about PrEP?

4. How about other sources: family and media? What do they say about PrEP? How much did you listen to them when you made your decision regarding PrEP?

Section 2: Social Dynamics pertaining to PrEP

5. Does anyone know someone on PrEP? Show of hands, how many people know someone on PrEP? Did you know someone on PrEP when you made your decision about PrEP? How much did their experience influence your decision on PrEP?

6. How much “peer pressure” is there to be, or not be, on PrEP? Who or where is this pressure coming from?

Probe: Tell us about PrEP-related discussions and messages on dating/hook-up apps, and if you feel pressure to be on PrEP when on these apps.

7. Has anyone experienced rejection from a potential sexual partner because you disclosed you are not on PrEP? If so, tell me about what happened.

8. Let’s talk about PrEP stigma; is the label “PrEP whore” or “Truvada whore” something you have heard? Is this term still being used? Are there other examples of stigma about PrEP?

Section 3: PrEP’s Impact on HIV-related Sexual Scripting among MSM

9. How is PrEP changing sex between men?

Probe: What about sexual encounters between HIV negative and positive men? How do you feel about having sex with someone who is HIV positive now that PrEP is around?

Section 4: Perceptions of Risk and Risk Reduction Methods

10. How concerned are you all about getting HIV?

Probe: Why are you, or are you not concerned?

11. How do you protect yourselves from HIV? How confident are you that you will remain HIV negative.

Section 5: Hypothetical – the Future of HIV Prevention

12. What would you most like to see HIV prevention look like in 5 years?

[Probe if needed:] Do you expect there will be changes in what can be done for HIV prevention?

Probe: Injectable medication taken before or after an exposure, microbicides contained in lube, vaccine

Closing

Thank you for your time and thoughtful responses. That is all the questions that I have. We have left time now for you to tell me if we missed something or if you have something you would like to say about the topics covered tonight/today.

[Pause for participant response]

[Pause to allow participants to respond. You can ask a particular person if they have something to say.]

Thank you again for taking time out of your day to come talk with us about these topics. I will turn off the recorders. At this point, we are asking everyone to complete the survey we started at the beginning. Once the survey is complete, we will provide you with a token of appreciation and you are free to go. Any questions or concerns?

[STOP RECORDERS]

END TIME: __:__AM/PM