ArticleSocial science & medicine (1982)2024
Individual & joint associations of sexual stigma and mental distress with PrEP uptake, adherence and persistence among US gay and bisexual men.
Article in Social science & medicine (1982), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The trial behind it
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Who cites it
3 citing papers in PubMed.
- Validation of the PrEP Use Self-Efficacy (PrEP-Use) Scale Among Sexual Minority Men.AIDS education and prevention : official publication of the International Society for AIDS Education · 2025Trial
- Moderating Role of Condom-Use Inertia on the Association Between Status Quo Bias and Pre-Exposure Prophylaxis Resistance Intention Among Chinese Men Who Have Sex With Men: Cross-Sectional Study.JMIR public health and surveillance · 2026Article
- Mortgage discrimination at the intersection of race and sexual orientation and its association with HIV incidence among sexual minority men in the U.S.Annals of epidemiology · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundSexual stigma, mental health disorders, and socioeconomic disparities present important yet incompletely understood barriers to PrEP adoption among gay men and other men who have sex with men (MSM). This study examines how these factors interact and affect PrEP uptake, adherence, and persistence among MSM.
methodsData from the 2018 and 2019 American Men's Internet Survey cycles, involving 6907 adult MSM eligible for PrEP, were analyzed. We assessed sexual stigma heterogeneity among this group using latent class analysis and investigated individual relationships between i) stigma class membership, ii) mental distress, and PrEP engagement (past-year use, adherence, and persistence) using Poisson regression with a robust error variance, considering potential variations based on poverty status. The combined associations of sexual stigma and mental distress with PrEP engagement was evaluated using inverse probability weighting.
resultsFour distinct sexual stigma classes were identified, each exhibiting varied associations with PrEP engagement. Associations with mental distress lost statistical significance after adjusting for confounders. However, having both mental distress and sexual stigma was associated with lower past-year PrEP use, with the strongest association observed for those with anticipated healthcare stigma class membership and mental distress (aPR 0.53 [95% CI: 0.37, 0.76]). Sexual stigma accompanied by mental distress was also associated with significantly increased poor PrEP adherence, particularly among those with family and general social stigma class membership (aPR 2.31 [95% CI: 1.08, 4.97]).
conclusionsPsychosocial factors exert synergistic impacts on PrEP engagement among MSM. Tailored interventions addressing these subtleties may effectively optimize PrEP uptake and improve consistency of use among MSM.
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