The Influence of PrEP Stigma among Black and Latino MSM PrEP Adopters

 描述(申请人提供)：暴露前预防(PrEP)是一种生物医学艾滋病毒预防策略，有可能降低黑人和拉丁裔男男性行为者(BLMSM)的新艾滋病毒感染率，这两个人群是美国艾滋病毒/艾滋病流行的中心。然而，目前与使用PrEP相关的社会污名(即PrEP污名)可能会对采用PrEP的BLMSM的PrEP披露、传播、坚持和保留产生负面影响。围绕在同性恋社区实施PrEP的争议和争论导致了PrEP和那些使用它的人的污名。PREP使用者可能经历以负面看法(例如，被判断、被不公平对待)、污名化归因(例如，乱交、性行为不负责任、被错误地识别为HIV阳性)和污名化做法(例如，拒绝， 来自朋友、性伴侣、提供者和其他人的偏见、歧视)。本研究的目的是探索已采用PrEP的BLMSM中PrEP污名的性质和程度，并评估其对PrEP的披露、坚持和保留以及PrEP信息向其他潜在的BLMSM PrEP消费者的传播的影响。这项研究的具体目的是：1)调查BLMSM PrEP使用者如何经历PrEP污名(例如，预期的、内化的、已实施的)；2)评估BLMSM PrEP使用者披露PrEP的程度和背景以及将PrEP信息传播给其他潜在的BLMSM PrEP消费者；以及3)研究PrEP污名随着时间的推移对BLMSM PrEP使用者对PrEP的依附和保持的影响。为了实现这些目标，这项定性研究将涉及对50名黑人(N=25)和拉丁裔(N=25)MSM PrEP接受者和20名黑人(N=10)和拉丁裔(N=10)MSM非PrEP接受者进行深入访谈。BLMSM PrEP采用者将完成基线访谈和为期6个月的后续访谈。后续访谈将评估PrEP的保留、遵守、披露和传播方面的变化。与BLMSM非PrEP采用者的访谈将获得有关预期PrEP耻辱的信息，以及这可能如何影响寻求或不寻求PrEP的决定。还将与20名医疗提供者进行访谈，以评估他们对PrEP和PrEP耻辱的看法以及对PrEP实施的担忧。这项研究的发现将为寻求干预活动的发展提供信息 预防或减轻与采用PrEP相关的负面社会体验，并优化在少数族裔MSM中对PrEP的传播和保留。

 DESCRIPTION (provided by applicant):Pre-Exposure Prophylaxis (PrEP) is a biomedical HIV prevention strategy with the potential to reduce the rate of new HIV infection among black and Latino men who have sex with men (BLMSM), two populations at the center of the U.S. HIV/AIDS epidemic. However, the social stigma currently associated with the use of PrEP (i.e. PrEP stigma) may negatively influence PrEP disclosure, diffusion, adherence and retention among BLMSM who adopt PrEP. The controversy and contention surrounding the implementation of PrEP in the gay community has led to the stigmatization of PrEP and those who use it. PrEP users may experience PrEP stigma in the form of negative perceptions (e.g., being judged, being unfairly treated), stigmatizing attributions (e.g., promiscuous, sexually irresponsible, mistakenly identified as HIV-positive), and stigmatizing practices (e.g., rejection, prejudice, discrimination) from friends, sex partners, providers and others. The goals of this study are to explore the nature and extent of PrEP stigma among BLMSM who have adopted PrEP and to assess its influence on PrEP disclosure, adherence and retention, and the diffusion of PrEP information to other potential BLMSM PrEP consumers. The specific aims of this study are: 1) to examine how BLMSM PrEP adopters experience PrEP stigma (e.g., anticipated, internalized, enacted); 2) to assess the extent and context of PrEP disclosure and dissemination of PrEP information by BLMSM PrEP users to other potential BLMSM PrEP consumers; and 3) to examine the influence of PrEP stigma, over time, on adherence and retention to PrEP among BLMSM PrEP adopters. To achieve these aims, this qualitative study will involve conducing in- depth interviews with 50 black (N = 25) and Latino (N = 25) MSM PrEP adopters and 20 black (N = 10) and Latino (N = 10) MSM non-PrEP adopters. BLMSM PrEP adopters will complete both a baseline and a 6-month follow-up interview. Follow-up interviews will assess changes in PrEP retention, adherence, disclosure and dissemination. Interviews with BLMSM non-PrEP adopters will elicit information about anticipated PrEP stigma and how this may have influenced decisions to seek or not seek PrEP. Interviews will also be conducted with 20 medical providers to assess their perceptions of PrEP and PrEP stigma and concerns about the implementation of PrEP. The findings from this study will inform the development of intervention activities that seek to prevent or mitigate the negative social experiences associated with PrEP adoption and to optimize diffusion and retention to PrEP among minority MSM.