title: Will I? Won't I? Why do men who have sex with men present for post-exposure prophylaxis for sexual exposures?
abstract: BACKGROUND
  Failures of post-exposure prophylaxis following sexual exposure (PEPSE) to prevent seroconversion have been reported and are often associated with ongoing risk exposure. Understanding why men who have sex with men (MSM) access PEPSE on some occasions and not others may lead to more effective health promotion and disease prevention strategies
  
  
  METHODS
  A qualitative study design using semi-structured interviews of 15 MSM within 6 months of them initiating PEPSE treatment at an HIV outpatient service in Brighton, UK.
  
  
  RESULTS
  PEPSE seeking was motivated by a number of factors: an episode that related to a particular sexual partner and their behaviour; the characteristics of the venue where the risk occurred; the respondent's state of mind and influences of alcohol and recreational drug use; and their perceived beliefs on the effectiveness of PEPSE. Help was sought in the light of a "one-off" or "unusual" event. Many respondents felt they were less likely to behave in a risky manner following PEPSE.
  
  
  CONCLUSIONS
  If PEPSE is to be effective as a public health measure, at risk individuals need to be empowered to make improved risk calculations from an increased perception that they could be exposed to HIV if they continue their current behaviour patterns. The concern is that PEPSE was sought by a low number of MSM implying that a greater number are not using the service based on failure to make accurate risk calculations or recognise high-risk scenarios.
authors.affiliation: Brighton and Sussex Medical School, The Audrey Emerton Building, The Royal Sussex County Hospital, Eastern Road, Brighton, BN2 5BE, UK. charliesayer@doctors.org.uk
authors.forename: C
authors.initials: C
authors.lastname: Sayer
authors.forename: M
authors.initials: M
authors.lastname: Fisher
authors.forename: E
authors.initials: E
authors.lastname: Nixon
authors.forename: K
authors.initials: K
authors.lastname: Nambiar
authors.forename: D
authors.initials: D
authors.lastname: Richardson
authors.forename: N
authors.initials: N
authors.lastname: Perry
authors.forename: C
authors.initials: C
authors.lastname: Llewellyn
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D004739:England; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D036301:Qualitative Research; D012307:Risk Factors; D012309:Risk-Taking; D047568:Unsafe Sex / Q000523:psychology*; D055815:Young Adult