Sarah K Calabrese1,2,3, John F Dovidio2,3,4, Mehrit Tekeste1, Tamara Taggart2,3, Rachel W Galvao2, Cara B Safon2, Tiara C Willie2,3, Abigail Caldwell5, Clair Kaplan5, Trace S Kershaw2,3. 1. Department of Psychology, George Washington University, Washington, DC. 2. Social and Behavioral Sciences Department, Yale School of Public Health, Yale University, New Haven, CT. 3. Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT. 4. Department of Psychology, Yale University, New Haven, CT. 5. Planned Parenthood of Southern New England, New Haven, CT.
Abstract
BACKGROUND: Pre-exposure prophylaxis (PrEP) uptake has lagged among US women. PrEP stigma is a recognized barrier to uptake among men who have sex with men but remains largely unexplored among women. This study examined the pervasiveness of PrEP stigma among US women and its implications for uptake. SETTING/ METHODS: In a 2017 online survey of Planned Parenthood patients drawn from the 3 cities with the highest numbers of new HIV infections in Connecticut, 597 heterosexually active, HIV-negative, PrEP-inexperienced women reported background characteristics, 2 dimensions of anticipated PrEP stigma (PrEP-user stereotypes and PrEP disapproval by others), and 3 indicators of potential PrEP uptake (interest in learning more about PrEP, intention to use PrEP, and comfort discussing PrEP with a provider). RESULTS: Participants commonly perceived PrEP-user stereotypes, with many believing that others would regard them as promiscuous (37%), HIV-positive (32%), bad (14%), or gay (11%) if they used PrEP. Thirty percent would feel ashamed to disclose PrEP use. Many participants expected disapproval by family (36%), sex partners (34%), and friends (25%). In adjusted analyses, perception of PrEP-user stereotypes was uniquely associated with less comfort discussing PrEP with a provider. Expected PrEP disapproval by others was uniquely associated with less PrEP interest, less intention to use PrEP, and less comfort discussing PrEP with a provider. Exploratory moderation analyses suggested that intention to use PrEP was greatest when participants anticipated low levels of both PrEP-user stereotypes and PrEP disapproval by others. CONCLUSIONS: Findings highlight the need for positive messaging targeting potential PrEP users and their social networks to increase PrEP acceptance and uptake.
BACKGROUND: Pre-exposure prophylaxis (PrEP) uptake has lagged among US women. PrEP stigma is a recognized barrier to uptake among men who have sex with men but remains largely unexplored among women. This study examined the pervasiveness of PrEP stigma among US women and its implications for uptake. SETTING/ METHODS: In a 2017 online survey of Planned Parenthood patients drawn from the 3 cities with the highest numbers of new HIV infections in Connecticut, 597 heterosexually active, HIV-negative, PrEP-inexperienced women reported background characteristics, 2 dimensions of anticipated PrEP stigma (PrEP-user stereotypes and PrEP disapproval by others), and 3 indicators of potential PrEP uptake (interest in learning more about PrEP, intention to use PrEP, and comfort discussing PrEP with a provider). RESULTS:Participants commonly perceived PrEP-user stereotypes, with many believing that others would regard them as promiscuous (37%), HIV-positive (32%), bad (14%), or gay (11%) if they used PrEP. Thirty percent would feel ashamed to disclose PrEP use. Many participants expected disapproval by family (36%), sex partners (34%), and friends (25%). In adjusted analyses, perception of PrEP-user stereotypes was uniquely associated with less comfort discussing PrEP with a provider. Expected PrEP disapproval by others was uniquely associated with less PrEP interest, less intention to use PrEP, and less comfort discussing PrEP with a provider. Exploratory moderation analyses suggested that intention to use PrEP was greatest when participants anticipated low levels of both PrEP-user stereotypes and PrEP disapproval by others. CONCLUSIONS: Findings highlight the need for positive messaging targeting potential PrEP users and their social networks to increase PrEP acceptance and uptake.
Authors: Jeffrey T Parsons; H Jonathon Rendina; Jonathan M Lassiter; Thomas H F Whitfield; Tyrel J Starks; Christian Grov Journal: J Acquir Immune Defic Syndr Date: 2017-03-01 Impact factor: 3.731
Authors: Matt G Mutchler; Bryce McDavitt; Mansur A Ghani; Kelsey Nogg; Terrell J A Winder; Juliana K Soto Journal: AIDS Patient Care STDS Date: 2015-06-29 Impact factor: 5.078
Authors: Jonathan Garcia; Caroline Parker; Richard G Parker; Patrick A Wilson; Morgan Philbin; Jennifer S Hirsch Journal: Health Educ Behav Date: 2015-08-26
Authors: Sarah K Calabrese; Mehrit Tekeste; Kenneth H Mayer; Manya Magnus; Douglas S Krakower; Trace S Kershaw; Adam I Eldahan; Lauren A Gaston Hawkins; Kristen Underhill; Nathan B Hansen; Joseph R Betancourt; John F Dovidio Journal: AIDS Patient Care STDS Date: 2019-02 Impact factor: 5.078
Authors: Anne M Teitelman; Deepti Chittamuru; Beryl A Koblin; Annet Davis; Bridgette M Brawner; Danielle Fiore; Tarashon Broomes; Geneva Ortiz; Debbie Lucy; Hong-Van Tieu Journal: Arch Sex Behav Date: 2020-04-08
Authors: Laia Vazquez; Anthony P Moll; Alexa Kacin; Ntombi Euginia Ndlovu; Sheela V Shenoi Journal: AIDS Patient Care STDS Date: 2019-05 Impact factor: 5.078
Authors: Anar S Patel; Lakshmi Goparaju; Jessica M Sales; Cyra Christina Mehta; Oni J Blackstock; Dominika Seidman; Igho Ofotokun; Mirjam-Colette Kempf; Margaret A Fischl; Elizabeth T Golub; Adaora A Adimora; Audrey L French; Jack DeHovitz; Gina Wingood; Seble Kassaye; Anandi N Sheth Journal: J Acquir Immune Defic Syndr Date: 2019-04-15 Impact factor: 3.731
Authors: Sarah K Calabrese; Rachel W Galvao; John F Dovidio; Tiara C Willie; Cara B Safon; Clair Kaplan; Abigail Caldwell; Oni Blackstock; Nicole J Phillips; Trace S Kershaw Journal: AIDS Patient Care STDS Date: 2020-03 Impact factor: 5.078
Authors: Maria Pyra; Laura K Rusie; Kristin Keglovitz Baker; Andie Baker; Jessica Ridgway; John Schneider Journal: Am J Public Health Date: 2020-01-16 Impact factor: 9.308