” (HIV-negative MSM, FG). A large minority of

HIV-positive as well as HIV-negative participants raised the issue of longer term side-effects, especially http://www.selleckchem.com/products/Dasatinib.html those who were more familiar with the effects of ARVs: Does it not have any side effects inside my body? ‘Cause from my reading as well, some of these anti-retrovirals have got side-effects with the lungs, with the kidneys and stuff. So, in the long run, if I get used to drinking this pill and I’m actually not exposed because I’m thinking I might be at risk of getting exposed, am I not doing more damage to myself in my body? (HIV-negative African woman) PrEP candidacy and low perceptions of HIV risk Many participants described scepticism in taking PrEP daily, especially if they were not always exposed to or at risk of HIV transmission. As such, perceptions of HIV transmission risk played an important role in potential uptake of PrEP. Several participants rejected the use of PrEP because they perceived themselves to be at a very low risk. For the majority of HIV-negative participants, this was because most adopted serosorting or believed they could accurately tell if a potential partner was HIV positive and avoid sex with him or her: “I wouldn’t just [want to] take a risk because it’s already defining as a risk, I mean, it’s a risk, it’s already been defined as a risk and since I’m a little bit risk averse…I won’t just do anything” (HIV-negative African

man). HIV stigma and assumptions about disclosure appeared to inform these strategies. For example, some HIV-negative participants assumed that HIV-disclosure to sexual partners “was the law” (HIV-negative MSM, FG), and that their sexual partners were not HIV positive. Those HIV-negative participants in serodiscordant relationships and HIV-positive participants suggested that condoms, and the nature of their relationships (eg, monogamous), already

helped manage their risks, and that the additional benefit from PrEP was unnecessary. One man in a serodiscordant relationship explained: Right now in my current situation as, I’m doing a monogamous relationship and everything like that, again I don’t think even in that [instance] I don’t think I would take the pills even though it would Drug_discovery be an extra measure…I think I would feel comfortable enough in the current situation. (HIV-negative MSM) PrEP and concerns with other risks Both HIV-positive and HIV-negative participants identified risk of other STIs as a concern for themselves and their sexual partners. Heterosexual African participants, especially African women, also talked of the risk of pregnancy. For those participants who were either living with HIV, or who had experience of serodiscordant relationships, other health risks posed to the HIV-positive sexual partner through PrEP use were also identified: when I’m looking at condom use it’s not just HIV that you’re protecting yourself against but some other STIs as well. So you’re killing two birds with one stone, more like it.