title: Stigma and Conspiracy Beliefs Related to Pre-exposure Prophylaxis (PrEP) and Interest in Using PrEP Among Black and White Men and Transgender Women Who Have Sex with Men.
abstract: The HIV/AIDS epidemic in the US continues to persist, in particular, among race, sexual orientation, and gender minority populations. Pre-exposure prophylaxis (PrEP), or using antiretroviral medications for HIV prevention, is an effective option, but uptake of PrEP has been slow. Sociocultural barriers to using PrEP have been largely underemphasized, yet have the potential to stall uptake and, therefore, warrant further understanding. In order to assess the relationships between potential barriers to PrEP (i.e., PrEP stigma and conspiracy beliefs), and interest in PrEP, Black men and transgender women who have sex with men (BMTW, N = 85) and White MTW (WMTW, N = 179) were surveyed at a gay pride event in 2015 in a large southeastern US city. Bivariate and multivariate logistic regression analyses were completed to examine factors associated with PrEP interest. Among the full sample, moderate levels of PrEP awareness (63%) and low levels of use (9%) were observed. Believing that PrEP is for people who are promiscuous (stigma belief) was strongly associated with lack of interest in using PrEP, and individuals who endorsed this belief were more likely to report sexual risk taking behavior. Conspiracy beliefs related to PrEP were reported among a large minority of the sample (42%) and were more frequently reported among BMTW than WMTW. Given the strong emphasis on the use of biomedical strategies for HIV prevention, addressing sociocultural barriers to PrEP access is urgently needed and failure to do so will weaken the potential benefits of biomedical prevention.
authors.affiliation: Human Development and Family Studies, University of Connecticut, Storrs, CT, USA. lisaanne.eaton@gmail.com.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Eaton
authors.affiliation: Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA.
authors.forename: Seth C
authors.initials: SC
authors.lastname: Kalichman
authors.affiliation: Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA.
authors.forename: Devon
authors.initials: D
authors.lastname: Price
authors.affiliation: Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Finneran
authors.affiliation: Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA.
authors.forename: Aerielle
authors.initials: A
authors.lastname: Allen
authors.affiliation: Human Development and Family Studies, University of Connecticut, Storrs, CT, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Maksut
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D003469:Culture; D000069480:Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination / Q000627:therapeutic use*; D015658:HIV Infections / Q000517:prevention & control*; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D065129:Pre-Exposure Prophylaxis; D057545:Social Stigma; D063106:Transgender Persons / Q000523:psychology*; D014481:United States; D047568:Unsafe Sex; D044465:White People / Q000523:psychology*; D055815:Young Adult; D005260:Female
chemical_list: D019380:Anti-HIV Agents; D000069480:Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination
keywords: Conspiracy beliefs; HIV prevention; PrEP; Stigma beliefs