Influence of Stigma on Pre-Exposure Prophylaxis (PrEP) Care Continuum Among Men and Transwomen Who Have Sex with Men (MTWSM) in the United States
International Journal of HIV/AIDS Prevention, Education and Behavioural Science
Volume 5, Issue 2, December 2019, Pages: 134-140
Received: Oct. 15, 2019;
Accepted: Nov. 9, 2019;
Published: Nov. 17, 2019
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Jude Ssenyonjo, Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
Roman Shrestha, Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
Michael Copenhaver, Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
Despite evidence from recent trials of the efficacy of pre-exposure prophylaxis (PrEP) in reducing the risk of contracting HIV, PrEP uptake has been slow due to a range of social, structural, and behavioral factors. In this systematic review, we examined the influence of stigma on the PrEP care continuum among men and transwomen who have sex with men (MTWSM). We conducted a literature search in the PubMed electronic database (2012–2018) that focused on the PrEP care continuum among high-risk MTWSM. We explored studies that specifically looked at the influence of stigma on the PrEP cascade among these socially disadvantaged populations. Our search yielded 161 articles, of which nine were ultimately included in our systematic review. The results showed a significant association between stigma and unwillingness to seek or use PrEP suggesting that stigma may negatively affect willingness and uptake of PrEP among these high-risk groups.
Influence of Stigma on Pre-Exposure Prophylaxis (PrEP) Care Continuum Among Men and Transwomen Who Have Sex with Men (MTWSM) in the United States, International Journal of HIV/AIDS Prevention, Education and Behavioural Science.
Vol. 5, No. 2,
2019, pp. 134-140.
CDC. HIV/AIDS Basic Statistics. 2017 December 18, 2017 [cited 2018 April 9, 2018]; HIV/AIDS Statistics]. Available from: https://www.cdc.gov/hiv/basics/statistics.html.
Holtgrave, D. R., et al., Costs, consequences and feasibility of strategies for achieving the goals of the National HIV/AIDS strategy in the United States: a closing window for success? AIDS Behav, 2012. 16 (6): p. 1365-72.
Singh, S., A. Mitsch, and B. Wu, HIV Care Outcomes Among Men Who Have Sex With Men With Diagnosed HIV Infection - United States, 2015. MMWR Morb Mortal Wkly Rep, 2017. 66 (37): p. 969-974.
Anderson, P. L., et al., Emtricitabine-tenofovir concentrations and pre-exposure prophylaxis efficacy in men who have sex with men. Sci Transl Med, 2012. 4 (151): p. 151ra125.
Grant, R. M., et al., Uptake of pre-exposure prophylaxis, sexual practices, and HIV incidence in men and transgender women who have sex with men: a cohort study. Lancet Infect Dis, 2014. 14 (9): p. 820-9.
Smith, D. K., 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): p. 1291-5.
Marcus, J. L., et al., Successful Implementation of HIV Preexposure Prophylaxis: Lessons Learned From Three Clinical Settings. Curr HIV/AIDS Rep, 2016. 13 (2): p. 116-24.
Peng, P., et al., A Global Estimate of the Acceptability of Pre-exposure Prophylaxis for HIV Among Men Who have Sex with Men: A Systematic Review and Meta-analysis. AIDS Behav, 2018. 22 (4): p. 1063-1074.
Kelley, C. F., et al., Applying a PrEP Continuum of Care for Men Who Have Sex With Men in Atlanta, Georgia. Clin Infect Dis, 2015. 61 (10): p. 1590-7.
Adams, J. W., J. Shinefeld, and K. A. Brady, Acceptability of Oral Preexposure Prophylaxis Among Men Who Have Sex With Men in Philadelphia. J Acquir Immune Defic Syndr, 2016. 73 (3): p. e62-e65.
Arnold, T., et al., Social, structural, behavioral and clinical factors influencing retention in Pre-Exposure Prophylaxis (PrEP) care in Mississippi. PLoS One, 2017. 12 (2): p. e0172354.
Biello, K. B., et al., The "Safe Sex" Conundrum: Anticipated Stigma From Sexual Partners as a Barrier to PrEP Use Among Substance Using MSM Engaging in Transactional Sex. AIDS Behav, 2017. 21 (1): p. 300-306.
Bil, J. P., et al., The Acceptability of Pre-Exposure Prophylaxis: Beliefs of Health-Care Professionals Working in Sexually Transmitted Infections Clinics and HIV Treatment Centers. Front Public Health, 2018. 6: p. 5.
Calabrese, S. K., et al., 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): p. 226-40.
Eaton, L. A., et al., 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. AIDS Behav, 2017. 21 (5): p. 1236-1246.
Fallon, S. A., et al., Awareness and Acceptability of Pre-exposure HIV Prophylaxis Among Men Who have Sex with Men in Baltimore. AIDS Behav, 2017. 21 (5): p. 1268-1277.
Garcia, J., et al., Psychosocial Implications of Homophobia and HIV Stigma in Social Support Networks: Insights for High-Impact HIV Prevention Among Black Men Who Have Sex With Men. Health Educ Behav, 2016. 43 (2): p. 217-25.
Garcia, M. and A. L. Harris, PrEP awareness and decision-making for Latino MSM in San Antonio, Texas. PLoS One, 2017. 12 (9): p. e0184014.
Golub, S. A. and K. E. Gamarel, The impact of anticipated HIV stigma on delays in HIV testing behaviors: findings from a community-based sample of men who have sex with men and transgender women in New York City. AIDS Patient Care STDS, 2013. 27 (11): p. 621-7.
Golub, S. A., K. E. Gamarel, and A. Surace, Demographic Differences in PrEP-Related Stereotypes: Implications for Implementation. AIDS Behav, 2017. 21 (5): p. 1229-1235.
Holloway, I. W., et al., Facilitators and Barriers to Pre-Exposure Prophylaxis Willingness Among Young Men Who Have Sex with Men Who Use Geosocial Networking Applications in California. AIDS Patient Care STDS, 2017. 31 (12): p. 517-527.
Oldenburg, C. E., et al., Differences in Attitudes About HIV Pre-Exposure Prophylaxis Use Among Stimulant Versus Alcohol Using Men Who Have Sex with Men. AIDS Behav, 2016. 20 (7): p. 1451-60.
Oldenburg, C. E., et al., State-level structural sexual stigma and HIV prevention in a national online sample of HIV-uninfected MSM in the United States. Aids, 2015. 29 (7): p. 837-45.
Perez-Figueroa, R. E., et al., Acceptability of PrEP Uptake Among Racially/Ethnically Diverse Young Men Who Have Sex With Men: The P18 Study. AIDS Educ Prev, 2015. 27 (2): p. 112-25.
Franks, J., et al., Sex, PrEP, and Stigma: Experiences with HIV Pre-exposure Prophylaxis Among New York City MSM Participating in the HPTN 067/ADAPT Study. AIDS Behav, 2018. 22 (4): p. 1139-1149.
Calabrese, S. K., et al., HIV Pre-Exposure Prophylaxis Stigma as a Multidimensional Barrier to Uptake Among Women Who Attend Planned Parenthood. J Acquir Immune Defic Syndr, 2018. 79 (1): p. 46-53.
Goparaju, L., et al., Stigma, Partners, Providers and Costs: Potential Barriers to PrEP Uptake among US Women. J AIDS Clin Res, 2017. 8 (9).