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Predictors of Anticipated PrEP Stigma among Women with Self-Reported Problematic Substance Use: Implications for Engaging Women in the PrEP Care Continuum

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Abstract

Pre-exposure prophylaxis (PrEP) is an effective HIV prevention method, but it has been underutilized by women. Anticipated stigma regarding use of PrEP is a contributing factor in the underutilization of this prevention strategy. The current study explored the relationships among PrEP stigma, sex risk (i.e., inconsistent condom use, condomless sex with persons of unknown serostatus, or sex in exchange for money or drugs), substance use, attitudes toward HIV testing, and medical mistrust. Participants were 106 primarily ethnic-minority women who reported recent substance use and agreed to participate in a study exploring HIV prevention attitudes. Within this sample, the majority of participants had one or more CDC-defined PrEP indications. Findings indicate that medical mistrust was associated with perceived PrEP stereotypes and HIV testing attitudes. These results provide some insight into reasons for low PrEP uptake among women at risk for HIV. Implications for HIV prevention with women are discussed.

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Funding

This project was partially supported by a grant from the Substance Abuse and Mental. Health Services Administration (SAMHSA) H79TI080734 (PI: Heads). The content is solely the. responsibility of the authors and does not necessarily represent the official views of SAMHSA.

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Authors and Affiliations

  1. Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center At Houston, 1941 East Road, BBSB Suite 1238, Houston, TX, 77054, USA

    Angela M. Heads, Robert Suchting, Luba Yammine & Adrienne Gilmore-Thomas

  2. Department of Emergency Medicine, McGovern Medical School, University of Texas Health, Science Center at Houston, Houston, TX, USA

    Mandy J. Hill

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  1. Angela M. Heads
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  2. Mandy J. Hill
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  3. Robert Suchting
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Correspondence to Angela M. Heads.

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Conflicts of interest

The authors declare that they have no conflict of interest. The lead author’s work was supported in part by the Substance Abuse and Mental Health Services Administration (SAMHSA) Grant H79TI080734. The content is solely the responsibility of the authors and does not necessarily represent the official views of SAMHSA.

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All procedures were performed in accordance with the ethical standards of institutional review board (UTHealth McGovern Medical School Committee on the Protection of Human Subjects Institutional Review Board Protocol # HSC-MS-19–0585 and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Heads, A.M., Hill, M.J., Suchting, R. et al. Predictors of Anticipated PrEP Stigma among Women with Self-Reported Problematic Substance Use: Implications for Engaging Women in the PrEP Care Continuum. Arch Sex Behav 50, 2955–2964 (2021). https://doi.org/10.1007/s10508-021-02031-7

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