Stigma can prevent women from receiving PrEP

Fear of being accused of having promiscuous sexual relations and discrimination because of HIV-positive status causes many women to refuse to take pre-exposure HIV prevention (PrEP), scientists from the George Washington University (USA) have established.

As follows from the results of the work published this week in the Journal of Acquired Immune Deficiency Syndrome, in the United States alone there are more than 200,000 women who need PrEP. However, only a quarter of them take drugs.

"The social condemnation of PrEP, including stereotypes about those who take drugs for HIV prevention, can prevent women from starting treatment," says study author Sarah Calabrese of the University of George Washington, DC.

"It is important for us to explain the negative attitude of women towards PrEP so that we can correct it and start promoting a positive idea about HIV prevention."

The study, which is part of a larger project aimed at expanding PrEP services among families planning pregnancy, has studied stigma as a potential barrier to receiving pre-exposure prophylaxis by women, as studies from an early focus group showed that this could be a serious problem, Calabrese said.

"Currently in the US there is only one form of PrEP: one tablet once a day. If you take therapy as prescribed, you can reduce the risk of HIV infection by more than 90 percent, "she said.

To assess how stigma affects the risk of taking prevention, Calabrese and her colleagues interviewed 597 HIV-negative American women planning a pregnancy at the age of 18. Scientists found that less than a quarter of them (23%) were aware of PrEP.

Women provided information about themselves, and before they answered questions about their attitude to PrEP, they watched a short video on this topic.

According to the results of the survey, scientists found that many of them are afraid of discrimination if they start taking PrEP.

At the same time, about 37% of respondents believe that they will be accused of promiscuous sexual intercourse, 32% - that they think they have HIV, and they try to hide their status, and 14% - that they will be caught in "bad" connections.

A similar number of respondents were also worried about disapproval from family and friends, and that they would be ashamed to admit that they used PrEP.

About one third of the participants in the study said that they feared that their families or partners would not approve the use of drugs, and about 25% said that their friends would condemn them for it.

"Many women may be negative about PrEP and think that their friends and relatives will not approve of their use of prevention, and these negative conclusions, like the expected disapproval from others, can seriously affect the use of the pre-exposure HIV prevention option," said Calabrese.

According to her, to encourage women to use PrEP, it is necessary among health care providers, as well as in the media and public health, to promote a more positive attitude to pre-exposure HIV prevention.

"Wide awareness and public recognition can significantly affect the range of use of PrEP and reduce the level of fears among women in need of prevention."

Public health representatives - especially in preventive institutions - must undergo comprehensive PrEP training in order to be able to consult their patients in a qualified manner.

In addition, added Calabrese, other resources should be involved, for example, brochures and videos in the waiting rooms.