’ But you’re also putting that person, because that person’s immune system full read might be weak. They’re also putting that person at risk of other STIs as well, instead of using condoms. So I think it makes people more ignorant of the other things as well. And it makes people just more focused on just HIV and not other STIs. And then risk of pregnancy as well is likely to get high, provided the people are not on any other form of contraception….No, I think…no, from the way you’ve said it to me…I wouldn’t even tell it to people. (HIV-negative African woman) Most HIV-positive participants described anxieties about PrEP in relation

to their inability to be in effective control of HIV prevention. One woman could not imagine agreeing to her HIV-negative sexual partner using PrEP: “[PrEP] is too risky for him because I don’t know when he stop using it, what will happen to him” (HIV-positive African woman, FG). Moral barriers to PrEP PrEP emerged as a

highly contentious issue because of the perceived negative implications it had for existing risk management strategies and HIV prevention. Many participants viewed PrEP as problematic because they perceived that others would stop using condoms if PrEP was available. That is, they distinguished between how they might use PrEP and how they perceived others would use it. For some, the concern was in relation to reduced condom use: “it’ll be like…women burning their bras. It’ll be all these guys [whipping] off their condoms, do you know what I mean?” (HIV-negative MSM). Other participants were also concerned with bigger changes in sexual practice, such as increased risk taking: Are you trying to eliminate the condom?…There is no place for a condom at all when it’s

like this. So I think it actually encourages people to be more promisc…not promiscuous, but to be more…I don’t know [if] ‘ignorant’ is the right word, but to be less careful ‘cause they know ‘oh, there’s that pill’. And it’s not even cost-effective than just getting a condom or using…PEP once in a blue moon. (HIV-negative African woman) Not all participants were opposed to PrEP and many viewed PrEP as a good addition to HIV prevention options. However, there was still concern about how PrEP would be accessed. Overall it was hoped that it would be made available only under strict Anacetrapib conditions to ensure the ‘right’ people received it and that it was used in the ‘correct’ way: I believe it should be available in Scotland. But, it should be under strict control to make sure the person who takes it knows that he, or she is not protected to full extent from other infections, and HIV either. (HIV-negative MSM) Discussion This is the first qualitative study in the UK to report on the acceptability of PrEP.