Social Stigmas Hamper Use of HIV-Prevention Drug
The FDA approved the HIV prevention drug known as PrEP (pre-exposure prophylaxis) in 2012. Since that time, however, social stigmas surrounding the drug have become significant barriers for uptake. The CDC states that roughly one out of four men would benefit from using PrEP, but “data show that the number of PrEP users has increased year-over-year since being approved, but uptake is still not commensurate with the need,” said Professor Christian Grov (Graduate School of Public Health & Public Policy). In a study co-published in Sociology of Health & Illness with Mark Pawson, a doctoral candidate at The Graduate School, CUNY, they took a deeper look at those pejorative attitudes.
Public health messages about HIV carry certain stereotypes about responsibility. Drawing from that context, Pawson and Grov reviewed a series of focus groups in New York City composed of gay and bisexual men. They found that some men viewed PrEP users as promiscuous, irresponsible, and less likely to use condoms, which reverberated with the notion of sexual deviancy that originated from HIV messaging.
Even though PrEP is a safe alternative method of HIV prevention and is recommended for men who are having high-risk sex with men, Pawson said that the drug “challenges the messaging that the one and only acceptable form of practicing HIV prevention is using condoms and anything outside of that is seen as immoral.”
Monogamy and promiscuity also affected men’s views about PrEP usage. If someone was in a monogamous relationship with a partner who had HIV, that was an acceptable reason to use PrEP, whereas if someone was using the drug so they could have casual sex without condoms, that was deemed immoral. Those attitudes again reflect the general messaging about HIV that promotes responsibility, i.e. condom usage, over irresponsibility, i.e. no condom usage. Participants believed that PrEP users were more likely to have unprotected sex and blamed PrEP for the spread of other sexually transmitted diseases in the gay and bisexual communities.
“There is a lot of nuance in how to practice safe sex and some of the older prevention messaging is creating conflict with some of these newer prevention strategies,” Pawson said. He believes that creating more inclusive messaging that describes the various options and their effectiveness would help dispel some of these attitudes and could be even more effective at reducing HIV.
Colleges and Schools
Graduate School of Public Health and Health Policy
The Graduate Center
“Risky Business: The Stigma of PrEP and the Consequences for HIV Prevention” (GC News)
“The perception of PrEP as an excuse for promiscuity” (SPH News)