Table 2. Key themes and illustrative quotes.

Theme	Illustrative Quotes
Theme 1: Key Motivators	“There are a lot of guys who don’t want to use condom, and so for those times i’m really glad that. You know this is something i’ve been on.” “A lot of positive homosexuals moving around having zero safeguard issues for themselves and for others right, so I wanted to safeguard myself as priority, just in case there is the issue or a slip that happens right.” “PrEP does give me the blanket. the umbrella of safety.” “Last year, my VDRL was positive so I had to take an injection. So, that’s why I thought it will work for me because my sex encounter was on a large scale. So, to prevent myself from all this, I thought prep is a good option.” “I met a guy who is HIV positive in his initial stages. I was..I knew, I know that guy since 5 years. We are very good friends and initially I was not that sexually active and we both became sexually active in 2020 after the first lockdown”
Theme 2: Concerns and dislikes around PrEP	“The KFT test, there’s a Kidney Function Test. I, yes, I did have an increase on few pointers. So I will be doing my..and that’s one of the reasons I stopped this start of the year, because I wanted to see whether, if I stopped prep, will it come down, and it did.” “For me time is an issue like it’s to be taken at the same time everyday. Like, I started to take it at night and my doctor asked me to take it at that time everyday. So, I just wish there weren’t any time boundations and that we can take it at any time of the day”
Theme 3: Experiences during accessing PrEP	Prep was something which was introduced to me by a friend. He is from the US. And he was visiting India And then I was traveling to US in 2017–18. That’s when I met a lot of people who were on prep I also got an ad on my.. on my instagram I think. Either instagram or Facebook regarding this organization that helps provide prep to.. to queer people in India I started getting more information about some of the NGOs having the alternative of partnering with the companies here to get prep. “He (doctor) actually spoke to me for half an hour. He explained everything and then it was quite helpful and he sort of broaden my perspective, about what’s the pros, cons, everything is and that’s when I was a little more comfortable about getting on with it.” “Preferably, in person. . .I can meet online as well, but it’s.. it just helps to first meet in person, and then you can follow up online.” “It wasn’t available at any of the medical stores near my house. I tried one or two, but they had no idea what prep is. Maybe if I had said truvada then they must have understood but not when I said prep.”
Theme 4: Risky Behavior with PrEP use	“No, definitely. I’ll use condoms when I’m penetrating anyone, definitely I will. I need to use, there is no exception over there.” “So, initially, I always used to use protection even with prep, but I think recently, probably from the past month, I have become a little more relaxed about it” “Honestly I do not do anal intercourse with everyone. So, uh..and when I do it, it’s like 50–50 depends upon the person, right, as I said, so sometimes I feel like not using condoms and sometimes I feel like I should use condoms.” “Mostly, I did not. Only sometimes. It’s like if the other person gave it to me or asked me to use it, only then because I don’t like using condoms as such.” “Like before I didn’t know about the STIs, I was like I won’t use condoms if I’m going to get on prep, but then the STIs thing came.. I was like.. okay, I have to use condoms. Okay, yeah and condoms are kind of fun.”
Theme 5: Adherence and Trust with PrEP	“I just read it online and I’ve gone through the 2-1-1 method. I read something about prep online and well, it was promising. So yeah. I wanted to get on it. People, I’ve seen people who are on it. I’ve heard stories from them, what they did. Without a condom obviously. And I felt like, they’re safe so, yeah.”
Theme 6: Long Term goals with PrEP	“I think the reason would be the same if I’m dating somebody and we decided to be monogamous.”
Theme 7: Cost and affordability	“I mean anything cheaper.. being cheaper is great, I feel. I can afford it, as of now, I don’t mind that cost. I think it’s a great price cost,. . .but I’m sure there are other people who can’t afford it” “Of course, it’s not an affordable drug per se, to the Indian market.” “I do wish it was cheaper, but I like, relatively it is affordable. But I think for more people to adopt it, it needs to be cheaper. It’s too expensive.”
Theme 8: Community and peers’ reactions to PrEP use	“Being my closest friend he reacts in that way, like what happened to you why are you dating that guy? Why are you troubling your body?”
Theme 9: Long Acting Injectable	It’s a very good idea, because having a pill, you might forget your pill any day like it happened to me once, yeah I missed and it’s also a hassle like every day, taking a pill, if you’re outside your house, you have to always carry your pill, and going somewhere else. I really want it to come very, very fast because taking tablets every day is a.. I don’t know, I just don’t like it. Yeah, I would like to know more about its side effects, adverse effects and all that.