Pre-exposure prophylaxis use and discontinuation among Brazilian gay, bisexual, and other men who have sex with men: examining the role of internalized homonegativity and discrimination

Abstract Background: Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention strategy yet use and persistence among populations at high vulnerability to HIV in Brazil remains suboptimal. We sought to quantify internalized homonegativity and discrimination using multi-item validated instruments and to estimate their associations with PrEP use and discontinuation among gay, bisexual, and other men who have sex with men (MSM). Methods: A cross-sectional, web-based survey was conducted from November 2021 to January 2022, recruiting a convenience sample of MSM