Current Perspectives on the Impact of Pre-Exposure Prophylaxis Stigma Regarding Men Who Have Sex with Men in the United States

Abstract Pre-exposure prophylaxis or PrEP is a Food and Drug Administration approved human immunodeficiency virus (HIV) prevention tool that reduces the risk of infection by greater than 90%. While it does not provide protection against other sexually transmittable infections and blood-borne illnesses such as hepatitis C, syphilis, chlamydia, and gonorrhea, it is a highly effective in reducing the risk of transmission of HIV among men who have sex with men. Despite the success of PrEP, there remain barriers to PrEP uptake rooted in stigmatized perspectives shared by health professionals, patients, and community members. The insidious impact of stigma associated with HIV/AIDS has permeated throughout the LGBTQ+ community, healthcare system, society in general and to this day, continues to exacerbate structural and social determinants of health disparities amongst sexual and gender minorities. While the initial resistance to PrEP has abated over time, stigmatized perspectives regarding PrEP continue to impede those at greatest risk from benefiting from effective preventive care.

[1]  V. Guilamo-Ramos,et al.  The Invisible US Hispanic/Latino HIV Crisis: Addressing Gaps in the National Response. , 2019, American journal of public health.

[2]  A. Gifford,et al.  Roadblocks to PrEP: What Medical Records Reveal About Access to HIV Pre-exposure Prophylaxis , 2019, Journal of General Internal Medicine.

[3]  Emma C Spencer,et al.  Changes in HIV Preexposure Prophylaxis Awareness and Use Among Men Who Have Sex with Men — 20 Urban Areas, 2014 and 2017 , 2019, MMWR. Morbidity and mortality weekly report.

[4]  R. Chou,et al.  Preexposure Prophylaxis for the Prevention of HIV Infection: Evidence Report and Systematic Review for the US Preventive Services Task Force. , 2019, JAMA.

[5]  M. Lewis,et al.  “A Gay Man and a Doctor are Just like, a Recipe for Destruction”: How Racism and Homonegativity in Healthcare Settings Influence PrEP Uptake Among Young Black MSM , 2018, AIDS and Behavior.

[6]  L. Fraenkel,et al.  Stigma and Shame Experiences by MSM Who Take PrEP for HIV Prevention: A Qualitative Study , 2018, American journal of men's health.

[7]  B. Sommers,et al.  Intra‐Ethnic Coverage Disparities among Latinos and the Effects of Health Reform , 2016, Health services research.

[8]  Patrick D. Herron.  Ethical Implications of Social Stigma Associated with the Promotion and Use of Pre-Exposure Prophylaxis for HIV Prevention. , 2016, LGBT health.

[9]  R. Wolitski,et al.  Vital Signs: Estimated Percentages and Numbers of Adults with Indications for Preexposure Prophylaxis to Prevent HIV Acquisition--United States, 2015. , 2015, Journal of the Mississippi State Medical Association.

[10]  R. Wolitski,et al.  Vital Signs: Estimated Percentages and Numbers of Adults with Indications for Preexposure Prophylaxis to Prevent HIV Acquisition--United States, 2015. , 2015, MMWR. Morbidity and mortality weekly report.

[11]  K. Underhill,et al.  How Stigma Surrounding the Use of HIV Preexposure Prophylaxis Undermines Prevention and Pleasure: A Call to Destigmatize "Truvada Whores". , 2015, American journal of public health.

[12]  P. Halkitis,et al.  Acceptability of PrEP Uptake Among Racially/Ethnically Diverse Young Men Who Have Sex With Men: The P18 Study. , 2015, AIDS education and prevention : official publication of the International Society for AIDS Education.

[13]  J. Dovidio,et al.  The Impact of Patient Race on Clinical Decisions Related to Prescribing HIV Pre-Exposure Prophylaxis (PrEP): Assumptions About Sexual Risk Compensation and Implications for Access , 2014, AIDS and Behavior.

[14]  Stephenie R. Chaudoir,et al.  Stereotypes about people living with HIV: implications for perceptions of HIV risk and testing frequency among at-risk populations. , 2012, AIDS education and prevention : official publication of the International Society for AIDS Education.

[15]  L. Wood.  Why I Voted “No” to Truvada PrEP , 2012, Annals of Internal Medicine.

[16]  David V Glidden,et al.  Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. , 2010, The New England journal of medicine.

[17]  B. J. Anderson.  HIV Stigma and Discrimination Persist, Even in Health Care. , 2009, The virtual mentor : VM.

[18]  E. Schor.  The Henry J. Kaiser Family Foundation. , 1990, Academic medicine : journal of the Association of American Medical Colleges.