PrEP Stigma: Implicit and Explicit Drivers of Disparity

Sarit A Golub, Sarit A Golub

Abstract

Purpose of review: Despite its promise as an HIV prevention strategy, PrEP uptake remains slow, especially among highest priority populations. One factor that may be impeding implementation and driving disparities is PrEP-related stigma. This paper reviews the role of PrEP-related stigma in PrEP access, adherence, and persistence and examines its antecedents and consequences.

Recent findings: Although PrEP stigma is often experienced at the community level (i.e., by potential and current users), it can be reinforced and even amplified by public health programs, policy, and research. PrEP stigma disproportionately impacts disadvantaged groups and impedes scalability by influencing behavior of both patients and providers. Reducing PrEP stigma and its negative impact on the epidemic requires a significant shift in perspective, language, and programs. Such a shift is necessary to ensure broader reach of PrEP as a prevention strategy and improve its utilization by the individuals who need it most.

Keywords: HIV/AIDS; Implementation; Pre-exposure prophylaxis (PrEP); Prevention; Sexual health; Stigma.

Conflict of interest statement

Conflict of Interest/Disclosure Statement

Dr. Golub reports non-financial support from Gilead Sciences in the form of medication supply for an NIH-funded PrEP demonstration project, outside the submitted work.

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