暴露前预防用药的污名：导致差异的内隐和外显驱动因素。
PrEP Stigma: Implicit and Explicit Drivers of Disparity.
机构信息
Department of Psychology, Hunter College and Graduate Center of the City University of New York (CUNY), 695 Park Avenue, New York, NY, 10065, USA.
出版信息
Curr HIV/AIDS Rep. 2018 Apr;15(2):190-197. doi: 10.1007/s11904-018-0385-0.
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.
摘要
目的综述：尽管作为一种 HIV 预防策略具有广阔前景，但接受 PrEP 的人数仍然较少，尤其是在高危人群中。阻碍 PrEP 实施和导致差异的一个因素可能是与 PrEP 相关的耻辱感。本文综述了与 PrEP 相关的耻辱感在 PrEP 获得、坚持和持续使用方面的作用，并探讨了其相关因素和后果。
最近发现：尽管 PrEP 耻辱感通常发生在社区层面（即潜在和现有的使用者），但公共卫生计划、政策和研究可能会强化甚至放大这种耻辱感。PrEP 耻辱感不成比例地影响弱势群体，并通过影响患者和提供者的行为来阻碍可扩展性。减少 PrEP 耻辱感及其对疫情的负面影响需要从观念、语言和项目上进行重大转变。这种转变对于确保更广泛地将 PrEP 作为一种预防策略，并提高最需要它的人的使用率是必要的。
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