“You Don't Want Your Parents Knowing That You're Taking Pre-exposure Prophylaxis”: Pre-exposure Prophylaxis Stigma Among Black and Latinx Adolescents

Abstract

Pre-exposure prophylaxis (PrEP) stigma is an understudied barrier to PrEP uptake among Black and Latinx adolescents. U.S. Black and Latinx adolescents (13–17 years) completed an online survey or participated in focus groups/interviews. Associations between PrEP stigma, PrEP disclosure, and provider-initiated PrEP discussion preferences were examined using logistic-regression models. Qualitative data provided further context to quantitative findings. The survey sample included 208 adolescents (53% female; 58% Latinx; M = 15 years), with 98% endorsing PrEP stigma. The qualitative sample included 26 adolescents (54% female; 34% Latinx; M = 15 years). PrEP stigma was associated with lower odds of PrEP disclosure to parents/guardians, and preference for health care providers to initiate PrEP-related discussions only with patients the provider judged to be at high risk for HIV. Qualitative data supported quantitative results: Adolescents endorsed multiple negative stereotypes about PrEP users. Mitigating PrEP stigma among Black and Latinx adolescents is an important step in overcoming challenges related to PrEP uptake.

Knowledge, Attitudes, and Utilization of HIV PrEP among Black College Students in the United States: A Systematic Review

“…This is consistent with empirical findings of general patient aversion to the disclosure of levels of sexual risk behavior in HIV care [31][32][33][34]. Also, resistance to PrEP discussion may be driven by overall societal stigma negatively associated with living with HIV [35], which may be exacerbated by significant HIV PrEP coverage inequity in the Black demographic. Emphasis must also be placed on increasing linkage to HIV preventive care or treatment for spouses or sexual partners of interested students who might be at high risk for HIV infection.…”