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PrEP Stigma as a Minority Stressor among Black Sexual Minority Men: A Mixed-Methods Study
Rodman Turpin1, Aaron D Camp2,3, C J Mandell4
1Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA. RTurpin@gmu.edu.
AIDS and Behavior
|September 17, 2024
Summary
Pre-exposure prophylaxis (PrEP) stigma significantly reduces PrEP use among Black sexual minority men. Addressing PrEP stigma through culturally competent strategies is crucial for HIV prevention and health equity.
Area of Science:
- Public Health
- Sociomedical Sciences
- Epidemiology
Background:
- Black sexual minority men (BSMM) experience disproportionately high HIV rates.
- Pre-exposure prophylaxis (PrEP) uptake remains low in this demographic.
- Minority stress theory suggests PrEP stigma may worsen marginalization based on race and sexuality.
Purpose of the Study:
- To determine if PrEP-specific stigma is associated with reduced PrEP uptake among BSMM.
- To qualitatively explore how PrEP use is stigmatized within the BSMM community.
Main Methods:
- Exploratory sequential mixed-methods approach.
- Cross-sectional analysis of pilot data (n=151) using modified Poisson regression.
- Qualitative thematic analysis of interviews (n=23).
Main Results:
- PrEP stigma was associated with less than half the PrEP use (aPR=0.43) among BSMM, independent of sociobehavioral factors.
- Qualitative themes included PrEP-specific sexual stigma, intersections of PrEP and HIV stigma, and PrEP misinformation.
- Stigma themes were rooted in minority stressors related to sexuality and race.
Conclusions:
- PrEP stigma is a significant barrier to PrEP uptake among BSMM.
- Culturally competent PrEP promotion is essential to address stigma.
- Addressing stigma is vital for health equity and ending the HIV epidemic.
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