Abstract
Men who have sex with men (MSM) are vulnerable to HIV infection. Although daily oral pre-exposure prophylaxis (PrEP) prevents HIV among MSM, its usage remains low. We conducted virtual in-depth interviews (IDIs) and focus groups (FGs) with Black, Hispanic/Latino, and White MSM consisting of current PrEP users and those aware of but not currently using PrEP. We delved into their preferences regarding six emerging PrEP products: a weekly oral pill, event-driven oral pills, anal douche/enema, anal suppository, long-acting injection, and a skin implant. Our mixed methods analysis involved inductive content analysis of transcripts for thematic identification and calculations of preferences. Among the sample (n = 98), the weekly oral pill emerged as the favored option among both PrEP Users and PrEP Aware IDI participants. Ranking exercises during FGs also corroborated this preference, with the weekly oral pill being most preferred. However, PrEP Users in FGs leaned toward the long-acting injectable. Conversely, the anal suppository and douche/enema were the least preferred products. Overall, participants were open to emerging PrEP products and valued flexibility but expressed concerns about limited protection for products designed solely for receptive sex. Public health practitioners should tailor recommendations based on individuals' current sexual behaviors and long-term vulnerability to infection.