Skip to main content
Erschienen in: AIDS and Behavior 5/2017

20.01.2017 | Original Paper

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

verfasst von: Lisa A. Eaton, Seth C. Kalichman, Devon Price, Stephanie Finneran, Aerielle Allen, Jessica Maksut

Erschienen in: AIDS and Behavior | Ausgabe 5/2017

Einloggen, um Zugang zu erhalten

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.
Literatur
2.
Zurück zum Zitat Purcell DW, Johnson CH, Lansky A, Prejean J, Stein R, Denning P, et al. Estimating the population size of men who have sex with men in the United States to obtain HIV and syphilis rates. Open AIDS J. 2012;6:98–107.CrossRefPubMedPubMedCentral Purcell DW, Johnson CH, Lansky A, Prejean J, Stein R, Denning P, et al. Estimating the population size of men who have sex with men in the United States to obtain HIV and syphilis rates. Open AIDS J. 2012;6:98–107.CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Matthews DD, Herrick AL, Coulter RW, Friedman MR, Mills TC, Eaton LA, et al. Running backwards: consequences of current HIV incidence rates for the next generation of black MSM in the United States. AIDS Behav. 2015. doi:10.1007/s10461-015-1158-z. Matthews DD, Herrick AL, Coulter RW, Friedman MR, Mills TC, Eaton LA, et al. Running backwards: consequences of current HIV incidence rates for the next generation of black MSM in the United States. AIDS Behav. 2015. doi:10.​1007/​s10461-015-1158-z.
4.
Zurück zum Zitat Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, Vargas L, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N. Engl J Med. 2010;363(27):2587–99.CrossRefPubMedPubMedCentral Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, Vargas L, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N. Engl J Med. 2010;363(27):2587–99.CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat McCormack S, Dunn DT, Desai M, Dolling DI, Gafos M, Gilson R, et al. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet. 2016;387(10013):53–60.CrossRefPubMedPubMedCentral McCormack S, Dunn DT, Desai M, Dolling DI, Gafos M, Gilson R, et al. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet. 2016;387(10013):53–60.CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Goedel WC, Halkitis PN, Greene RE, Hickson DA, Duncan DT. HIV risk behaviors, perceptions, and testing and preexposure prophylaxis (PrEP) awareness/use in grindr-using men who have sex with men in Atlanta, Georgia. JANAC. 2016;27(2):133–42.PubMed Goedel WC, Halkitis PN, Greene RE, Hickson DA, Duncan DT. HIV risk behaviors, perceptions, and testing and preexposure prophylaxis (PrEP) awareness/use in grindr-using men who have sex with men in Atlanta, Georgia. JANAC. 2016;27(2):133–42.PubMed
7.
Zurück zum Zitat Dolezal C, Frasca T, Giguere R, Ibitoye M, Cranston RD, Febo I, et al. Awareness of post-exposure prophylaxis (pep) and pre-exposure prophylaxis (PrEP) is low but interest is high among men engaging in condomless anal sex with men in Boston, Pittsburgh, and San Juan. AIDS Educa Prev. 2015;27(4):289–97.CrossRef Dolezal C, Frasca T, Giguere R, Ibitoye M, Cranston RD, Febo I, et al. Awareness of post-exposure prophylaxis (pep) and pre-exposure prophylaxis (PrEP) is low but interest is high among men engaging in condomless anal sex with men in Boston, Pittsburgh, and San Juan. AIDS Educa Prev. 2015;27(4):289–97.CrossRef
8.
Zurück zum Zitat Eaton LA, Driffin DD, Bauermeister J, Smith H, Conway-Washington C. Minimal awareness and stalled uptake of pre-exposure prophylaxis (PrEP) among at risk, HIV-negative, black men who have sex with men. AIDS Patient Care STDs. 2015;29(8):423–9.CrossRefPubMedPubMedCentral Eaton LA, Driffin DD, Bauermeister J, Smith H, Conway-Washington C. Minimal awareness and stalled uptake of pre-exposure prophylaxis (PrEP) among at risk, HIV-negative, black men who have sex with men. AIDS Patient Care STDs. 2015;29(8):423–9.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Smith DK, Van Handel M, Wolitski RJ, Stryker JE, Hall HI, Prejean J, et al. Vital signs: estimated percentages and numbers of adults with indications for preexposure prophylaxis to prevent HIV acquisition—United States, 2015. MMWR Morb Mortal Wkly Rep. 2015;64(46):1291–5.CrossRefPubMed Smith DK, Van Handel M, Wolitski RJ, Stryker JE, Hall HI, Prejean J, et al. Vital signs: estimated percentages and numbers of adults with indications for preexposure prophylaxis to prevent HIV acquisition—United States, 2015. MMWR Morb Mortal Wkly Rep. 2015;64(46):1291–5.CrossRefPubMed
10.
Zurück zum Zitat Mayer KH, Hosek S, Cohen S, Liu A, Pickett J, Warren M, et al. Antiretroviral pre-exposure prophylaxis implementation in the United States: a work in progress. J Int AIDS Soc. 2015;18(4 Suppl 3):19980.PubMedPubMedCentral Mayer KH, Hosek S, Cohen S, Liu A, Pickett J, Warren M, et al. Antiretroviral pre-exposure prophylaxis implementation in the United States: a work in progress. J Int AIDS Soc. 2015;18(4 Suppl 3):19980.PubMedPubMedCentral
11.
Zurück zum Zitat Auerbach JD, Hoppe TA. Beyond “getting drugs into bodies”: social science perspectives on pre-exposure prophylaxis for HIV. J Int AIDS Soc. 2015;18(4 Suppl 3):19983.PubMedPubMedCentral Auerbach JD, Hoppe TA. Beyond “getting drugs into bodies”: social science perspectives on pre-exposure prophylaxis for HIV. J Int AIDS Soc. 2015;18(4 Suppl 3):19983.PubMedPubMedCentral
12.
Zurück zum Zitat Haire BG. Preexposure prophylaxis-related stigma: strategies to improve uptake and adherence—a narrative review. HIV/Aids. 2015;7:241–9.PubMedPubMedCentral Haire BG. Preexposure prophylaxis-related stigma: strategies to improve uptake and adherence—a narrative review. HIV/Aids. 2015;7:241–9.PubMedPubMedCentral
13.
Zurück zum Zitat Calabrese SK, Underhill K. How stigma surrounding the use of hiv preexposure prophylaxis undermines prevention and pleasure: a call to destigmatize “Truvada Whores”. Am J Public Health. 2015;105(10):1960–4.CrossRefPubMedPubMedCentral Calabrese SK, Underhill K. How stigma surrounding the use of hiv preexposure prophylaxis undermines prevention and pleasure: a call to destigmatize “Truvada Whores”. Am J Public Health. 2015;105(10):1960–4.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Oldenburg CE, Mitty JA, Biello KB, Closson EF, Safren SA, Mayer KH, et al. Differences in attitudes about HIV pre-exposure prophylaxis use among stimulant versus alcohol using men who have sex with men. AIDS Behav. 2015. doi:10.1007/s10461-015-1226-4.PubMedPubMedCentral Oldenburg CE, Mitty JA, Biello KB, Closson EF, Safren SA, Mayer KH, et al. Differences in attitudes about HIV pre-exposure prophylaxis use among stimulant versus alcohol using men who have sex with men. AIDS Behav. 2015. doi:10.​1007/​s10461-015-1226-4.PubMedPubMedCentral
17.
Zurück zum Zitat Stigma EG. Notes on the management of spoiled identity. New York: Simon & Schuster Inc; 1963. Stigma EG. Notes on the management of spoiled identity. New York: Simon & Schuster Inc; 1963.
18.
Zurück zum Zitat Earnshaw VA, Chaudoir SR. From conceptualizing to measuring HIV stigma: a review of HIV stigma mechanism measures. AIDS Behav. 2009;13(6):1160–77.CrossRefPubMedPubMedCentral Earnshaw VA, Chaudoir SR. From conceptualizing to measuring HIV stigma: a review of HIV stigma mechanism measures. AIDS Behav. 2009;13(6):1160–77.CrossRefPubMedPubMedCentral
19.
20.
Zurück zum Zitat Underhill K, Morrow KM, Colleran C, Holcomb R, Calabrese SK, Operario D, et al. A qualitative study of medical mistrust, perceived discrimination, and risk behavior disclosure to clinicians by US male sex workers and other men who have sex with men: implications for biomedical HIV prevention. J Urban Health. 2015;92(4):667–86.CrossRefPubMedPubMedCentral Underhill K, Morrow KM, Colleran C, Holcomb R, Calabrese SK, Operario D, et al. A qualitative study of medical mistrust, perceived discrimination, and risk behavior disclosure to clinicians by US male sex workers and other men who have sex with men: implications for biomedical HIV prevention. J Urban Health. 2015;92(4):667–86.CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Eaton LA, Driffin DD, Kegler C, Smith H, Conway-Washington C, White D, et al. The role of stigma and medical mistrust in the routine health care engagement of black men who have sex with men. Am J Public Health. 2015;105(2):e75–82.CrossRefPubMedPubMedCentral Eaton LA, Driffin DD, Kegler C, Smith H, Conway-Washington C, White D, et al. The role of stigma and medical mistrust in the routine health care engagement of black men who have sex with men. Am J Public Health. 2015;105(2):e75–82.CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Maulsby C, Millett G, Lindsey K, Kelley R, Johnson K, Montoya D, et al. HIV among black men who have sex with men (MSM) in the United States: a review of the literature. AIDS Behav. 2014;18(1):10–25.CrossRefPubMed Maulsby C, Millett G, Lindsey K, Kelley R, Johnson K, Montoya D, et al. HIV among black men who have sex with men (MSM) in the United States: a review of the literature. AIDS Behav. 2014;18(1):10–25.CrossRefPubMed
23.
Zurück zum Zitat Bogart LM, Wagner G, Galvan FH, Banks D. Conspiracy beliefs about HIV are related to antiretroviral treatment nonadherence among african american men with HIV. J Acquir Immune Defic Syndr. 2010;53(5):648–55.PubMedPubMedCentral Bogart LM, Wagner G, Galvan FH, Banks D. Conspiracy beliefs about HIV are related to antiretroviral treatment nonadherence among african american men with HIV. J Acquir Immune Defic Syndr. 2010;53(5):648–55.PubMedPubMedCentral
24.
Zurück zum Zitat Bogart LM, Thorburn S. Are HIV/AIDS conspiracy beliefs a barrier to HIV prevention among African Americans? J Acquir Immune Defic Syndr. 2005;38(2):213–8.CrossRefPubMed Bogart LM, Thorburn S. Are HIV/AIDS conspiracy beliefs a barrier to HIV prevention among African Americans? J Acquir Immune Defic Syndr. 2005;38(2):213–8.CrossRefPubMed
25.
Zurück zum Zitat Eaton LA, Driffin DD, Smith H, Conway-Washington C, White D, Cherry C. Psychosocial factors related to willingness to use pre-exposure prophylaxis for HIV prevention among Black men who have sex with men attending a community event. Sexual Health. 2014;11(3):244–51.CrossRefPubMedPubMedCentral Eaton LA, Driffin DD, Smith H, Conway-Washington C, White D, Cherry C. Psychosocial factors related to willingness to use pre-exposure prophylaxis for HIV prevention among Black men who have sex with men attending a community event. Sexual Health. 2014;11(3):244–51.CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Cohen SE, Vittinghoff E, Bacon O, Doblecki-Lewis S, Postle BS, Feaster DJ, et al. High interest in preexposure prophylaxis among men who have sex with men at risk for HIV infection: baseline data from the US PrEP demonstration project. J Acquir Immune Defic Syndr. 2015;68(4):439–48.CrossRefPubMedPubMedCentral Cohen SE, Vittinghoff E, Bacon O, Doblecki-Lewis S, Postle BS, Feaster DJ, et al. High interest in preexposure prophylaxis among men who have sex with men at risk for HIV infection: baseline data from the US PrEP demonstration project. J Acquir Immune Defic Syndr. 2015;68(4):439–48.CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Krakower D, Ware N, Mitty JA, Maloney K, Mayer KH. HIV providers’ perceived barriers and facilitators to implementing pre-exposure prophylaxis in care settings: a qualitative study. AIDS Behav. 2014;18(9):1712–21.CrossRefPubMedPubMedCentral Krakower D, Ware N, Mitty JA, Maloney K, Mayer KH. HIV providers’ perceived barriers and facilitators to implementing pre-exposure prophylaxis in care settings: a qualitative study. AIDS Behav. 2014;18(9):1712–21.CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Calabrese SK, Earnshaw VA, Underhill K, Hansen NB, Dovidio JF. The impact of patient race on clinical decisions related to prescribing HIV pre-exposure prophylaxis (PrEP): assumptions about sexual risk compensation and implications for access. AIDS Behav. 2014;18(2):226–40.CrossRefPubMedPubMedCentral Calabrese SK, Earnshaw VA, Underhill K, Hansen NB, Dovidio JF. The impact of patient race on clinical decisions related to prescribing HIV pre-exposure prophylaxis (PrEP): assumptions about sexual risk compensation and implications for access. AIDS Behav. 2014;18(2):226–40.CrossRefPubMedPubMedCentral
29.
Zurück zum Zitat Grov C, Whitfield TH, Rendina HJ, Ventuneac A, Parsons JT. Willingness to take PrEP and potential for risk compensation among highly sexually active gay and bisexual men. AIDS Behav. 2015;19(12):2234–44.CrossRefPubMedPubMedCentral Grov C, Whitfield TH, Rendina HJ, Ventuneac A, Parsons JT. Willingness to take PrEP and potential for risk compensation among highly sexually active gay and bisexual men. AIDS Behav. 2015;19(12):2234–44.CrossRefPubMedPubMedCentral
30.
31.
Zurück zum Zitat Volk JE, Marcus JL, Phengrasamy T, Blechinger D, Nguyen DP, Follansbee S, et al. No new HIV infections with increasing use of HIV preexposure prophylaxis in a clinical practice setting. Clin Infect Dis. 2015;61(10):1601–3.CrossRefPubMedPubMedCentral Volk JE, Marcus JL, Phengrasamy T, Blechinger D, Nguyen DP, Follansbee S, et al. No new HIV infections with increasing use of HIV preexposure prophylaxis in a clinical practice setting. Clin Infect Dis. 2015;61(10):1601–3.CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Adams L, Balderson B, Packett B II, Brown K, Catz S. Providers’ perspectives on prescribing pre-exposure prophylaxis (PrEP) for HIV Prevention. HIV Spec. 2015;7(1):18–25. Adams L, Balderson B, Packett B II, Brown K, Catz S. Providers’ perspectives on prescribing pre-exposure prophylaxis (PrEP) for HIV Prevention. HIV Spec. 2015;7(1):18–25.
33.
Zurück zum Zitat Sullivan PS, Salazar L, Buchbinder S, Sanchez TH. Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS. 2009;23(9):1153–62.CrossRefPubMed Sullivan PS, Salazar L, Buchbinder S, Sanchez TH. Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS. 2009;23(9):1153–62.CrossRefPubMed
34.
Zurück zum Zitat Gamarel KE, Golub SA. Intimacy motivations and pre-exposure prophylaxis (PrEP) adoption intentions among HIV-negative men who have sex with men (MSM) in romantic relationships. Ann Behav Med. 2015;49(2):177–86.CrossRefPubMedPubMedCentral Gamarel KE, Golub SA. Intimacy motivations and pre-exposure prophylaxis (PrEP) adoption intentions among HIV-negative men who have sex with men (MSM) in romantic relationships. Ann Behav Med. 2015;49(2):177–86.CrossRefPubMedPubMedCentral
35.
Zurück zum Zitat Brooks RA, Kaplan RL, Lieber E, Landovitz RJ, Lee SJ, Leibowitz AA. Motivators, concerns, and barriers to adoption of preexposure prophylaxis for HIV prevention among gay and bisexual men in HIV-serodiscordant male relationships. AIDS Care. 2011;23(9):1136–45.CrossRefPubMedPubMedCentral Brooks RA, Kaplan RL, Lieber E, Landovitz RJ, Lee SJ, Leibowitz AA. Motivators, concerns, and barriers to adoption of preexposure prophylaxis for HIV prevention among gay and bisexual men in HIV-serodiscordant male relationships. AIDS Care. 2011;23(9):1136–45.CrossRefPubMedPubMedCentral
36.
Zurück zum Zitat Calabrese SK, Underhill K, Earnshaw VA, Hansen NB, Kershaw TS, Magnus M, et al. Framing HIV pre-exposure prophylaxis (PrEP) for the general public: how inclusive messaging may prevent prejudice from diminishing public support. AIDS Behav. 2016. doi:10.1007/s10461-016-1318-9.PubMedCentral Calabrese SK, Underhill K, Earnshaw VA, Hansen NB, Kershaw TS, Magnus M, et al. Framing HIV pre-exposure prophylaxis (PrEP) for the general public: how inclusive messaging may prevent prejudice from diminishing public support. AIDS Behav. 2016. doi:10.​1007/​s10461-016-1318-9.PubMedCentral
37.
Zurück zum Zitat Davis T, Zanjani F. Prevention of HIV among older adults: a literature review and recommendations for future research. J Aging Health. 2012;24(8):1399–420.CrossRefPubMed Davis T, Zanjani F. Prevention of HIV among older adults: a literature review and recommendations for future research. J Aging Health. 2012;24(8):1399–420.CrossRefPubMed
38.
Zurück zum Zitat Matthews DD, Herrick AL, Coulter RW, Friedman MR, Mills TC, Eaton LA, et al. Running backwards: consequences of current HIV incidence rates for the next generation of black MSM in the United States. AIDS Behav. 2016;20(1):7–16.CrossRefPubMedPubMedCentral Matthews DD, Herrick AL, Coulter RW, Friedman MR, Mills TC, Eaton LA, et al. Running backwards: consequences of current HIV incidence rates for the next generation of black MSM in the United States. AIDS Behav. 2016;20(1):7–16.CrossRefPubMedPubMedCentral
39.
Zurück zum Zitat Hutchinson AB, Begley EB, Sullivan P, Clark HA, Boyett BC, Kellerman SE. Conspiracy beliefs and trust in information about HIV/AIDS among minority men who have sex with men. J Acquir Immune Defic Syndr. 2007;45(5):603–5.CrossRefPubMed Hutchinson AB, Begley EB, Sullivan P, Clark HA, Boyett BC, Kellerman SE. Conspiracy beliefs and trust in information about HIV/AIDS among minority men who have sex with men. J Acquir Immune Defic Syndr. 2007;45(5):603–5.CrossRefPubMed
40.
Zurück zum Zitat Gillman J, Davila J, Sansgiry S, Parkinson-Windross D, Miertschin N, Mitts B, et al. The effect of conspiracy beliefs and trust on HIV diagnosis, linkage, and retention in young MSM with HIV. J Health Care Poor Underserved. 2013;24(1):36–45.CrossRefPubMed Gillman J, Davila J, Sansgiry S, Parkinson-Windross D, Miertschin N, Mitts B, et al. The effect of conspiracy beliefs and trust on HIV diagnosis, linkage, and retention in young MSM with HIV. J Health Care Poor Underserved. 2013;24(1):36–45.CrossRefPubMed
Metadaten
Titel
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
verfasst von
Lisa A. Eaton
Seth C. Kalichman
Devon Price
Stephanie Finneran
Aerielle Allen
Jessica Maksut
Publikationsdatum
20.01.2017
Verlag
Springer US
Erschienen in
AIDS and Behavior / Ausgabe 5/2017
Print ISSN: 1090-7165
Elektronische ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-017-1690-0

Weitere Artikel der Ausgabe 5/2017

AIDS and Behavior 5/2017 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.