Aspects of Pre-Exposure Prophylaxis Empowerment and Pitfalls Among Racial and Ethnic Young Men Who Have Sex With Men

HIV continues to disproportionately affect men who have sex with men (MSM), particularly Black and Latino populations. With pre-exposure prophylaxis (PrEP) now central to HIV prevention efforts, understanding perceptions of safer sex practices among racial and ethnic minority MSM is essential. This qualitative study conducted three focus groups with 22 Asian, Black, and Latino MSM aged 18 to 29 in Los Angeles County between January and April 2022 to explore how safer sex has evolved since PrEP’s Food and Drug Administration approval in 2012. Four themes emerged: (a) shifting definitions of safer sex, (b) sexual autonomy and empowerment, (c) peer perceptions and stigma surrounding PrEP use, and (d) provider judgment and limited knowledge. Participants described PrEP as a source of sexual agency but also highlighted ongoing stigma and discomfort when disclosing PrEP use or engaging with health care providers. Although all participants were active PrEP users, broader access disparities remain, particularly for MSM of color. The recent Food and Drug Administration approval of a biannual injectable PrEP offers a promising opportunity to expand uptake by reducing stigma, enhancing convenience, and improving adherence. These findings underscore the need for culturally responsive messaging, supportive clinical environments, and policy efforts to ensure equitable PrEP access for marginalized MSM. Public health practitioners and providers can use this insight to improve HIV prevention strategies and tailor interventions to the lived experiences of MSM of color.