1 Assistant Professor, Loma Linda University School of Public Health, Sanitarium Dr. Loma Linda, CA, USA.
2 Department of Neuro-Oncology, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY, USA.
Am J Mens Health. 2018 Nov;12(6):1843-1854. doi: 10.1177/1557988318797437. Epub 2018 Aug 30.
Pre-exposure prophylaxis (PrEP) uptake has been extremely low among key groups. PrEP-related stigma and shaming are potential barriers to uptake and retention in PrEP programs. There is a lack of literature describing PrEP stigma. In order to fill this gap, we recruited online 43 HIV-negative Men who have Sex with Men (MSM) who use PrEP. Semistructured interviews were conducted to explore their perceptions and experience of stigma related to PrEP use. Data were analyzed using Strauss and Corbin's grounded theory and constant comparison techniques to enhance understanding of the lived experiences of MSM who use PrEP. The participants experienced PrEP stigma as rejection by potential/actual partners, stereotypes of promiscuity or chemsex, and labeling of both the user and the medication. They connected PrEP stigma with HIV stigma, generational differences, moralization of condom use, and inability to embrace one's own sexuality. These findings point to a need to develop tailored interventions to address PrEP-related stigma and shaming for individuals, health-care professionals, and the MSM community-at-large.
暴露前预防（PrEP）在关键人群中的使用率极低。与 PrEP 相关的耻辱感和羞辱感是影响 PrEP 项目参与和保留的潜在障碍。目前缺乏描述 PrEP 耻辱感的文献。为了填补这一空白，我们招募了 43 名在线使用 PrEP 的 HIV 阴性男男性行为者（MSM）。进行半结构化访谈，以探讨他们对与 PrEP 使用相关的耻辱感的看法和体验。使用 Strauss 和 Corbin 的扎根理论和恒比比较技术对数据进行分析，以增强对使用 PrEP 的 MSM 生活经历的理解。参与者经历了 PrEP 耻辱感，包括潜在/实际伴侣的拒绝、滥交或嗑药的刻板印象，以及对使用者和药物的双重标签。他们将 PrEP 耻辱感与 HIV 耻辱感、代际差异、对避孕套使用的道德化以及无法接受自己的性行为联系起来。这些发现表明，需要为个人、医疗保健专业人员和整个 MSM 社区制定有针对性的干预措施，以解决与 PrEP 相关的耻辱感和羞辱感。
