Brooks Ronald A, Nieto Omar, Landrian Amanda, Fehrenbacher Anne, Cabral Alejandra
Department of Family Medicine, University of California, 10880 Wilshire Blvd., Suite 1800, Los Angeles, CA, 90024, USA.
Center for HIV Identification, Prevention, and Treatment Services (CHIPTS), University of California, Los Angeles, USA.
J Urban Health. 2020 Oct;97(5):679-691. doi: 10.1007/s11524-019-00371-3.
Black men who have sex with men (BMSM) are disproportionately affected by HIV infection in the USA. Pre-exposure prophylaxis (PrEP) is a proven efficacious biomedical prevention strategy with the potential to alter significantly the course of the epidemic in this population. However, the social stigma attached to PrEP and those who use it may act as a barrier to the uptake and continuation of PrEP among high-risk BMSM. In-depth, semi-structured qualitative interviews were conducted with 26 BMSM PrEP users to explore their experiences of stigma related to their PrEP use. BMSM reported multiple experiences or manifestations of PrEP-related stigma, which included (1) perception that PrEP users engage in elevated sexual risk behaviors; (2) conflicts in relationships attributed to PrEP; (3) experiences of discomfort or judgment from medical providers; (4) assumption that PrEP users are HIV-positive; and (5) gay stigma in families limiting PrEP disclosure. The experiences of stigma typically occur within the context of PrEP disclosure and have significant personal and social consequences for PrEP users. Efforts to address PrEP and other social-stigmas within the Black community may help facilitate PrEP uptake and continuation with BMSM.
在美国，与男性发生性关系的黑人（BMSM）受艾滋病毒感染的影响尤为严重。暴露前预防（PrEP）是一种经证实有效的生物医学预防策略，有可能显著改变该人群中的疫情发展态势。然而，与PrEP及其使用者相关的社会污名可能成为高危BMSM群体接受和持续使用PrEP的障碍。我们对26名使用PrEP的BMSM进行了深入的半结构化定性访谈，以探讨他们在使用PrEP过程中所经历的污名相关体验。BMSM报告了与PrEP相关污名的多种经历或表现形式，其中包括：（1）认为PrEP使用者从事更高风险的性行为；（2）因PrEP导致的人际关系冲突；（3）来自医疗服务提供者的不适或评判经历；（4）认为PrEP使用者是艾滋病毒阳性；（5）家庭中的同性恋污名限制了PrEP的披露。污名经历通常发生在PrEP披露的背景下，对PrEP使用者产生重大的个人和社会后果。在黑人社区中解决PrEP及其他社会污名的努力，可能有助于促进BMSM群体接受和持续使用PrEP。
