Department of Psychology, Hunter College and the Graduate Center of the City University of New York, New York, NY.
Department of Psychology, Hunter HIV/AIDS Research Team (HART), New York, NY.
J Acquir Immune Defic Syndr. 2018 Mar 1;77(3):264-271. doi: 10.1097/QAI.0000000000001592.
Preexposure prophylaxis (PrEP) stigma (ie, negative attitudes toward PrEP users) has been widely documented and is considered a significant barrier to implementation. However, few studies have examined PrEP stigma using implicit measures designed to reduce demand characteristics in responding. This study examined implicit PrEP- and HIV-related stigma among gay and bisexual men using geospatial social networking applications (ie, "hookup apps").
Participants were presented with 4 simulated online profiles (pretested for comparability) paired with each of the following characteristics: HIV negative, HIV positive, on PrEP, or substance user. Participants rated the profiles on attractiveness, desirability, trustworthiness, likelihood of condom use, and riskiness of sex.
There was no evidence of PrEP-related stigma, ie, participants did not rate profiles of PrEP users more negatively than profiles of HIV-negative individuals not disclosing PrEP use. However, profiles of HIV-positive individuals were rated significantly less attractive and desirable than HIV-negative or PrEP profiles. When the sample was split by history of PrEP use, negative ratings of HIV-positive profiles remained only among participants who had never taken PrEP. Participants with any history of PrEP use demonstrated no difference in ratings by HIV status.
These data provide the first empirical evidence for lower HIV stigma among PrEP users. Individuals who have used PrEP may "see" HIV-positive individuals differently than those without a history of PrEP use. The lack of evidence for PrEP-related stigma is encouraging and suggests that negative stereotypes about PrEP users may not extend to negative implicit judgments about them on social networking sites.
暴露前预防（PrEP）污名（即对 PrEP 用户的负面态度）已被广泛记录，并被认为是实施的一个重大障碍。然而，很少有研究使用旨在减少反应需求特征的内隐测量来检查 PrEP 污名。本研究使用地理空间社交网络应用程序（即“ hookup 应用程序”），检查了男同性恋和双性恋者的内隐 PrEP 和 HIV 相关污名。
参与者被呈现 4 个模拟在线个人资料（预先测试以确保可比性），并与以下特征中的每一个配对：HIV 阴性、HIV 阳性、接受 PrEP 治疗或药物使用者。参与者根据吸引力、吸引力、可信赖性、使用安全套的可能性和性行为风险对个人资料进行评分。
没有证据表明存在与 PrEP 相关的污名，即参与者没有将 PrEP 用户的个人资料评分比未透露 PrEP 使用情况的 HIV 阴性个体的个人资料评分更差。然而，HIV 阳性个体的个人资料吸引力和吸引力明显低于 HIV 阴性或 PrEP 个人资料。当按 PrEP 使用史对样本进行划分时，只有从未服用过 PrEP 的参与者对 HIV 阳性个人资料的负面评价仍然存在。有任何 PrEP 使用史的参与者在 HIV 状态下的评分没有差异。
这些数据提供了 PrEP 用户中 HIV 污名较低的第一个经验证据。使用过 PrEP 的人可能与没有 PrEP 使用史的人对 HIV 阳性个体的看法不同。没有 PrEP 相关污名的证据令人鼓舞，表明对 PrEP 用户的负面刻板印象可能不会延伸到他们在社交网站上的负面内隐判断。
