Persistent stigmatizing and negative perceptions of pre-exposure prophylaxis (PrEP) users: implications for PrEP adoption among Latino men who have sex with men

Abstract

The Centers for Disease Control and Prevention (CDC) estimates the lifetime HIV risk is one in four for Latino men who have sex with men (MSM). Pre-Exposure Prophylaxis (PrEP) is an efficacious biomedical prevention strategy to help prevent the acquisition of HIV. At present, there has been limited uptake of PrEP by Latino MSM. Unfortunately, the negative perceptions and social stigma surrounding PrEP and those who use it may deter uptake of this novel prevention strategy, particularly among high-risk Latino MSM. In this qualitative study, we explore the experiences of using PrEP among Latino MSM. Participants were recruited using gay-oriented social and sexual networking apps to complete an interviewer-administered, semi-structured qualitative interview. Thematic analysis was used to identify emerging themes relating to perceptions of PrEP users and PrEP as an HIV prevention strategy. Major themes included: feelings of protection and sexual freedom; negative and stigmatizing labels associated with PrEP use; assumptions about sexual behaviors and perceptions of sexual risk taking and irresponsibility; and attitudes related to PrEP use in relationships. A striking but not prevalent theme was the perception reported by participants that monolingual Spanish-speaking Latino MSM are skeptical about the effectiveness of PrEP. These findings suggest that efforts are needed to address the stigmatizing and negative perceptions of PrEP that persist in the gay community that may deter adoption among Latino MSM.

The acceptability and feasibility of a pilot study examining the impact of a mobile technology-based intervention informed by behavioral economics to improve HIV knowledge and testing frequency among Latinx sexual minority men and transgender women

“…As the current COVID-19 pandemic shows, mHealth technologies can provide a crucial link to relay quickly evolving information. Recent studies [10][11][12][13][14][15] including our own [8,16,17] have shown how increasingly restrictive U.S. immigration policies [18] have heightened the unwillingness of many LSMM and LTGW to engage with formal systems, [19] further elevating the need to utilize mHealth platforms to maintain a critical line of communication. MHealth shows potential to improve HIV testing frequency among these groups, [20][21][22][23][24][25] but evidence of technology disengagement over time [26] makes it unclear how best to achieve this outcome [9,[27][28][29][30].…”

Experiences of Pre-Exposure Prophylaxis (PrEP)–Related Stigma among Black MSM PrEP Users in Los Angeles

“…Another consequence of using PrEP identified in this study was the conflict it introduced in relationships, which often centered on questions or concerns regarding trust, potential infidelity, and monogamy. In general, PrEP is considered a necessary and acceptable form of HIV prevention for persons in HIV serodiscordant relationships [33]. It is primarily within the context of HIVnegative seroconcordant relationships that conflicts arise, wherein the use of PrEP by one partner is perceived as an indication of their infidelity or lack of trust in the relationship.…”

Predictors of Awareness, Accessibility and Acceptability of Pre-exposure Prophylaxis (PrEP) Among English- and Spanish-Speaking Latino Men Who have Sex with Men in Los Angeles, California

“…Social barriers comprise factors related to negative community perceptions of PrEP users, such as assumptions made about their promiscuity or HIV status [17,40]. Similar to other researchers, we suggest that PrEP navigators or peer educators may help bridge the current gap between high awareness and acceptability and low uptake of PrEP among Latino MSM and recommend that navigators or peer educators be other Latino MSM [11,[40][41][42][43]. We also suggest that PrEP delivery occur in safe spaces, such as community-based organizations that have earned the trust of Latino MSM.…”