Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave Suite 1400, Chicago, IL, 60611, USA.
Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
AIDS Behav. 2018 Sep;22(9):3044-3056. doi: 10.1007/s10461-018-2159-5.
Increasing the uptake of pre-exposure prophylaxis (PrEP) to prevent HIV acquisition among at-risk populations, such as young men who have sex with men (YMSM), is of vital importance to slowing the HIV epidemic. Stigma and negative injunctive norms, such as the so called "Truvada Whore" phenomenon, hamper this effort. We examined the prevalence and types of PrEP stigma and injunctive norm beliefs among YMSM and transgender women and associated individual and geospatial factors. A newly created measure of PrEP Stigma and Positive Attitudes was administered to 620 participants in an ongoing longitudinal cohort study. Results indicated lower stigma among White, compared to Black and Latino participants, and among participants not identifying as male. Prior knowledge about PrEP was associated with lower stigma and higher positive attitudes. PrEP stigma had significant geospatial clustering and hotspots were identified in neighborhoods with high HIV incidence and concentration of racial minorities, whereas coldspots were identified in areas with high HIV incidence and low LGBT stigma. These results provide important information about PrEP attitudes and how PrEP stigma differs between individuals and across communities.
提高艾滋病毒感染高风险人群（如男男性行为者）使用暴露前预防（PrEP）的比例，对于减缓艾滋病毒流行至关重要。污名化和负面的强制性规范，如所谓的“特鲁瓦达妓女”现象，阻碍了这一努力。我们调查了男男性行为者和跨性别女性中 PrEP 污名化和强制性规范信念的流行程度和类型，以及与个人和地理空间因素相关的因素。在一项正在进行的纵向队列研究中，向 620 名参与者发放了新创建的 PrEP 污名和积极态度量表。结果表明，与黑人及拉丁裔参与者相比，白人参与者的污名程度较低，而且自认为不是男性的参与者污名程度也较低。对 PrEP 的了解与较低的污名和更高的积极态度有关。PrEP 污名存在显著的地理空间聚类，在艾滋病毒发病率高和少数族裔集中的社区发现了热点，而在艾滋病毒发病率高和 LGBT 污名低的地区发现了冷点。这些结果提供了关于 PrEP 态度的重要信息，以及 PrEP 污名在个人和社区之间的差异。
