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The relationship between HIV pre-exposure prophylaxis stigma and treatment adherence among current HIV pre-exposure prophylaxis users in the Southeastern US

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dc.contributor.coauthorVan Gerwen, Olivia T.
dc.contributor.coauthorYigit, Ibrahim
dc.contributor.coauthorCrockett, Kaylee B.
dc.contributor.departmentDepartment of Psychology
dc.contributor.departmentDepartment of Psychology
dc.contributor.kuauthorTuran, Bülent
dc.contributor.schoolcollegeinstituteCollege of Social Sciences and Humanities
dc.date.accessioned2024-12-29T09:41:04Z
dc.date.issued2023
dc.description.abstractDespite efficacy in HIV prevention, Pre-exposure Prophylaxis (PrEP) is underutilized in the US, especially among populations at highest risk. PrEP-related stigma may play a role. We developed measures of PrEP-related stigma dimensions and PrEP adherence. We administered them to current PrEP users. We hypothesized that PrEP-related stigma would negatively impact PrEP adherence. Questionnaire measures were developed using data from previous qualitative work and existing validated HIV-related stigma measures. The resultant survey was administered to current PrEP users from two Birmingham, Alabama PrEP clinics. Plasma tenofovir disoproxil fumarate levels were collected to measure PrEP adherence. Exploratory factor analyses were performed to determine the factor structure of each PrEP-related stigma dimension (internalized, perceived, experienced, anticipated, disclosure concerns). Separate binary logistic (or linear) regressions were performed to assess associations between PrEP-related stigma dimensions and adherence (treatment adherence self-efficacy, self-reported adherence, and plasma tenofovir levels), adjusting for education, race, and time on PrEP. In 2018, 100 participants completed the survey, with 91 identifying as male and 66 as white. Only internalized stigma was associated with lower self-reported PrEP adherence. Exploratory mediation analyses suggested that the association between all stigma dimensions and self-reported PrEP adherence is mediated by PrEP adherence self-efficacy. No associations were found between any PrEP-related stigma measures and plasma tenofovir levels. Internalized PrEP stigma may reduce PrEP adherence, possibly by reducing PrEP adherence self-efficacy among experienced PrEP users. Further investigation of how stigma dimensions affect PrEP adherence in populations at risk for HIV may shed light on drivers of PrEP underutilization.
dc.description.indexedbyWoS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.issue5
dc.description.publisherscopeInternational
dc.description.sponsorsFunding text 1: OTVG has received research grant funding from Gilead Sciences, Inc. and Abbott Molecular and serves on advisory boards for Scynexis. No other authors have any financial disclosures. ; Funding text 2: We wish to acknowledge staff at the UAB 1917 Clinic and the Birmingham Magic City Wellness Center for their contributions to participant recruitment and data collection with particular thanks to Kachina Kudroff, Michael Fordham, Joshua Hicks, and Will Rainer. We thank the participants of this study for their time and effort sharing information for this study. OTVG has received research grant funding from Gilead Sciences, Inc. and Abbott Molecular and serves on advisory boards for Scynexis. No other authors have any financial disclosures.; Funding text 3: This research was supported by the University of Alabama at Birmingham Center for AIDS Research, a National Institutes of Health (NIH) funded program (P30 AI027767) that was made possible by the following institutes: NIAID, NCI, NICHD, NHLBI, NIDA, NIA, NIDDK, NIGMS, and OAR. The contents of this publication are the sole responsibility of the authors and do not represent the official views of the NIH or AHRQ.
dc.description.volume27
dc.identifier.doi10.1007/s10461-022-03883-3
dc.identifier.eissn1573-3254
dc.identifier.issn1090-7165
dc.identifier.quartileQ2
dc.identifier.scopus2-s2.0-85139620779
dc.identifier.urihttps://doi.org/10.1007/s10461-022-03883-3
dc.identifier.urihttps://hdl.handle.net/20.500.14288/23507
dc.identifier.wos865166800001
dc.keywordsAdherence
dc.keywordsHIV pre-exposure prophylaxis
dc.keywordsPrEP
dc.keywordsStigma
dc.languageen
dc.publisherSpringer
dc.relation.grantnoBirmingham Magic City Wellness Center
dc.relation.grantnoNational Institutes of Health, NIH, (P30 AI027767)
dc.relation.grantnoNational Institute on Drug Abuse, NIDA
dc.relation.grantnoNational Institute on Aging, NIA
dc.relation.grantnoNational Heart, Lung, and Blood Institute, NHLBI
dc.relation.grantnoNational Cancer Institute, NCI
dc.relation.grantnoNational Institute of General Medical Sciences, NIGMS
dc.relation.grantnoNational Institute of Allergy and Infectious Diseases, NIAID
dc.relation.grantnoNational Institute of Diabetes and Digestive and Kidney Diseases, NIDDK
dc.relation.grantnoGilead Sciences
dc.relation.grantnoOffice of AIDS Research, OAR
dc.relation.grantnoEunice Kennedy Shriver National Institute of Child Health and Human Development, NICHD
dc.relation.grantnoCenter for AIDS Research, University of Alabama at Birmingham, CFAR
dc.sourceAIDS and Behavior
dc.subjectPublic
dc.subjectEnvironmental
dc.subjectOccupational health
dc.subjectSocial sciences
dc.subjectBiomedical
dc.titleThe relationship between HIV pre-exposure prophylaxis stigma and treatment adherence among current HIV pre-exposure prophylaxis users in the Southeastern US
dc.typeJournal article
dspace.entity.typePublication
local.contributor.kuauthorTuran, Bülent
relation.isOrgUnitOfPublicationd5fc0361-3a0a-4b96-bf2e-5cd6b2b0b08c
relation.isOrgUnitOfPublication.latestForDiscoveryd5fc0361-3a0a-4b96-bf2e-5cd6b2b0b08c

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