Investigating Barriers and Enablers to Preventive HIV Access for Māori (PrEP Pilot Project)

Project Lead:

Dr Tanya Allport

Research Team:

Ben Barton

Dr Amohia Boulton

Associate Professor Clive Aspin

Advisory Group:

Milly Stewart

Hector Kaiwai

Dr Zarah Allport

Dr Jeannie Oliphant

Start / Finish Dates:

Start Date: March 2024

Projected Finish Date: December 2024

Project Overview:

While there are significant data gaps around HIV prevalence in Aotearoa New Zealand, research has highlighted that Māori men who have sex with men (MSM) are more likely to present with more advanced HIV¹ and are less likely to access services such as HIV/STI testing or HIV preventative medication². A recent report on the stigma experienced by Māori living with HIV in Aotearoa highlighted the negative effects of HIV on whānau and individuals³. Participants reported significant detriment to their ability to earn an income, harassment and abuse, social isolation, and anxiety/low mood, all as a direct result of their HIV status. Combined with the physical implications of HIV, these detrimental effects make HIV prevention a priority within Aotearoa today.

This ten-month pilot project was designed to test and inform a larger three-year study focusing on improving HIV prevention strategies for Māori by:

• Exploring the experiences of individuals accessing HIV preventive services.
• Identifying barriers and enablers to Pre-exposure Prophylaxis (PrEP) uptake.
• Identifying equitable service delivery approaches.

The study emphasises Māori perspectives and culturally appropriate methods to investigate access and suitability of sexual health services and HIV prevention strategies to effectively meet the needs of diverse Māori communities.

Progress to Date

Formed a Dedicated Advisory Group: Established an advisory group comprising experts, community leaders, and stakeholders with diverse perspectives, to guide the project and ensure cultural relevance.

Recruited Diverse Participants for In-Depth Interviews: Successfully recruited participants representing various backgrounds to capture a wide range of experiences and insights.

Data Collection:

Conducted and Concluded Interviews with All Participants: Completed in-depth interviews with all participants, gathering comprehensive qualitative data on their experiences and challenges related to sexual health services PrEP.

Preliminary Findings

Emerging themes highlight:

• Need for Accessible and Culturally Tailored Services: There is a critical demand for services that are accessible and tailored to the cultural contexts of Māori communities.
• Persistent Stigma Around Sexual Health: Stigma continues to be a significant barrier, discouraging individuals from seeking testing and treatment.
• Importance of Holistic Care and Trust-Building: Emphasising holistic approaches and building trust within healthcare services is essential for effective HIV prevention and sexual health care.

Next Steps

Data Analysis:

• Finalise the analysis to identify key barriers and enablers affecting HIV preventative sexual health services and PrEP access within Māori communities.

Dissemination of findings:

• Share findings with participants, their whānau, the advisory stakeholders, and the larger community via a series of targeted dissemination outputs.

References:

1. Dickson et. al, 2012
2. Ministry of Health, 2022
3. Takapou, 2021