[Men who have sex with men negotiating pleasure and prevention through HIV pre-exposure prophylaxis].

Prophylaxis based on antiretrovirals, such as pre-exposure prophylaxis to HIV (PrEP), has the potential to protect the populations most vulnerable to infection, which renews optimism for controlling the HIV epidemic. Against this backdrop, the aim of this article is to analyze the perceptions, negotiations and tensions surrounding the use of PrEP by men who have sex with men (MSM). This is a qualitative cross-section of a multicenter study, analyzing semi-structured interviews with 18 users of specialized HIV/AIDS healthcare facilities in the city of São Paulo/SP. The findings show that negotiating the use of PrEP among MSM involves looking for partners in which different sexual scenarios and the use of alcohol or drugs take place. Users gave PrEP the sense of facilitating the negotiation about the (non-)use of condoms and the (re)definition of care and prevention in different sexual-affective partnerships. The research broadens the debate on subjective aspects involving HIV prevention among MSM, especially with respect to its management in situations of negotiation involving other prevention strategies.