Perception of PrEP‐related stigma in PrEP users: Results from the ANRS‐PREVENIR cohort

Abstract

Introduction Since the advent of HIV pre‐exposure prophylaxis (PrEP), stigma has been shown to be a major barrier to its uptake and adherence. It is therefore essential to define the proportion of users who consider that PrEP can negatively impact their image and the factors associated with this perception. Method We performed a multivariable logistic regression on data from the 2567 participants in the ANRS‐PREVENIR study who answered the outcome question. Results Almost one‐third of the sample (comprising mostly cisgender men who have sex with men [94.3%]) considered that taking PrEP could give others a negative image of them. Younger participants (adjusted odds ratio [aOR] 0.98; 95% confidence interval [CI] 0.97–0.99) and more psychologically vulnerable participants (i.e., lower self‐esteem score [aOR 0.98; 95% CI 0.96–0.99] and higher depression score [aOR 1.02; 95% CI 1.00–1.03]) were also more likely to have this perception. In contrast, participants encouraged to take PrEP by their main partner (aOR 0.67; 95% CI 0.51–0.88) and friends (aOR 0.79; 95% CI 0.66–0.95), and those who protected themselves more because they had knowledge of their most recent sexual partner's HIV status (aOR 0.83; 95% CI 0.69–0.99) and systematic use of PrEP and/or condoms during intercourse in the previous 3 months (aOR 0.80; 95% CI 0.67–0.96) were less likely to have this perception. Discussion Given the strong interrelation between stigmatization (real or perceived), risky behaviours and adherence, our results emphasize the need for HIV prevention campaigns to promote a positive image of PrEP users. They also show that stigmatization and its effects need to be fully considered to improve HIV prevention offers to current and potential PrEP users who are most likely to be psychologically vulnerable.

The experience of healthcare workers to HIV pre-exposure prophylaxis (PrEP) implementation in low- and middle-income countries: a systematic review and qualitative meta-synthesis

“…In fact, not everybody will experience side effects, and most reported side effects are transient and slight ( 39 , 40 ). To address the knowledge gaps mentioned above, more promoting and health education campaigns should be conducted based on schools and communities in order to improve the conception of the potential PrEP clients and their parents or partners, and promote a positive image of PrEP users ( 41 , 42 ).…”