From hope to risk: representations of pre-exposure prophylaxis (PrEP) for HIV in the Spanish press (2018-2023)

Pre-exposure prophylaxis (PrEP) is a highly effective means of HIV prevention, reducing infection risk by up to 92% with consistent use. Despite its efficacy, PrEP adoption remains low due to structural, social and personal barriers, including stigmatisation. This study aimed to analyse representations of PrEP in the Spanish press from 2018 to 2023, focusing on how media coverage influences public perception and stigmatisation. We conducted a quantitative content analysis of articles from four Spanish newspapers (El País, La Vanguardia, El Mundo, and Ara). Articles were selected based on relevance to PrEP and analysed for themes of hope and risk, framing, metaphors, and stereotypes. The analysis revealed a shift from hopeful representations of PrEP as a biomedical advance to risk-focused narratives post-implementation. Media coverage predominantly linked PrEP to use by cisgender men, with limited mention of cisgender women and trans men. The presence of individual testimonies increased after PrEP became available, while collective voices from civil society organisations decreased. No differences were found in coverage between newspapers. The media's shift from hopeful to risk-oriented narratives may contribute to PrEP stigmatisation, potentially hindering its adoption. The study highlights the need for more inclusive and accurate media reporting to support PrEP uptake and reduce associated stigma.