An Experimental Investigation of Implicit HIV And PrEP Stigma: Evidence For Ancillary Benefits of Prep Use

Summary:
Few studies have examined PrEP stigma using implicit measures designed to reduce demand characteristics in responding. This study examined implicit PrEP- and HIV-related stigma among gay and bisexual men using geospatial social networking applications (i.e., “hookup apps”).  Participants were presented with four simulated online profiles (pre-tested for comparability) paired with each of the following characteristics: HIV-negative, HIV-positive, on PrEP, or Substance User. Participants rated the profiles on attractiveness, desirability, trustworthiness, likelihood of condom use, and riskiness of sex.  Results concluded that there was no evidence of PrEP-related stigma, i.e. participants did not rate profiles of PrEP users more negatively than profiles of HIV-negative individuals not disclosing PrEP use. However, profiles of HIV-positive individuals were rated significantly less attractive and desirable than HIV-negative or PrEP profiles. The date results demonstrated the first empirical evidence for lower HIV stigma among PrEP users. Individuals who have used PrEP may “see” HIV-positive individuals differently than those without a history of PrEP use. The lack of evidence for PrEP-related stigma is encouraging and suggests that negative stereotypes about PrEP users may not extend to negative implicit judgements about them on social networking sites.

Abstract:
BACKGROUND: PrEP stigma (i.e., negative attitudes toward PrEP users) has been widely documented and is considered a significant barrier to implementation. However, few studies have examined PrEP stigma using implicit measures designed to reduce demand characteristics in responding. This study examined implicit PrEP- and HIV-related stigma among gay and bisexual men using geospatial social networking applications (i.e., “hookup apps”).

METHODS: Participants were presented with four simulated online profiles (pre-tested for comparability) paired with each of the following characteristics: HIV-negative, HIV-positive, on PrEP, or Substance User. Participants rated the profiles on attractiveness, desirability, trustworthiness, likelihood of condom use, and riskiness of sex.

RESULTS: There was no evidence of PrEP-related stigma, i.e., participants did not rate profiles of PrEP users more negatively than profiles of HIV-negative individuals not disclosing PrEP use. However, profiles of HIV-positive individuals were rated significantly less attractive and desirable than HIV-negative or PrEP profiles. When the sample was split by history of PrEP use, negative ratings of HIV-positive profiles remained only among participants who had never taken PrEP. Participants with any history of PrEP use demonstrated no difference in ratings by HIV status.

CONCLUSIONS: These data provide the first empirical evidence for lower HIV stigma among PrEP users. Individuals who have used PrEP may “see” HIV-positive individuals differently than those without a history of PrEP use. The lack of evidence for PrEP-related stigma is encouraging and suggests that negative stereotypes about PrEP users may not extend to negative implicit judgements about them on social networking sites.

 

Citation:  Golub SA Lelutiu-Weinberger C, Surace A. An Experimental Investigation of Implicit HIV And PrEP Stigma: Evidence For Ancillary Benefits of Prep Use. J Acquir Immune Defic Syndr. 2017 Nov 13. doi: 10.1097/QAI.0000000000001592. [Epub ahead of print] Link to PubMed >>