How can clinicians help patients overcome stigma associated with HIV PrEP?
PrEP has been available in the U.S. since 2012. Studies have shown that, when taken daily, it is effective at preventing HIV infection. However, stigma remains a major barrier to more widespread use.
Infectious Disease News asked Raghavendra Tirupathi, MD, FACP, Infectious Disease News Editorial Board Member, medical director at Keystone Infectious Diseases/HIV, chair of infection prevention at Summit Health and clinical assistant professor of medicine at Penn State University School of Medicine, what clinicians can do to help patients overcome the stigma associated with HIV PrEP.
The high-risk sex that many individuals associate with PrEP use refers to condomless sex. PrEP is stigmatized because of the perception that it facilitates the same socially unacceptable behavior that would normally lead a person to become HIV positive. Hence, the stigma around PrEP is essentially stigmatizing sexual desire and expression itself.
This stigmatization is sadly very prevalent among health care providers and office staff and is an issue that has been recognized as an important barrier to successful implementation. HIV itself is socially stigmatized; hence, individuals “at risk” for HIV are also discredited by association.
As physicians, we need to change the narrative from one that says PrEP is for high-risk patients to one that gives more control to patients, with the message that PrEP is for people who want to reduce their anxiety about HIV infection and take greater responsibility for their sexual health. Allowing individuals to identify themselves as potential PrEP users because they want to feel better and stay healthy may increase acceptability. Only by addressing and reducing PrEP stigma will we be able to improve access, utilization and equitable distribution critical to accomplishing the goal of ending the HIV epidemic.
Click here to read the Cover Story, “Lessons from HIV, Ebola can help mitigate COVID-19 stigma.”