AI Article Synopsis
- - The study investigates how sexual stigma, mental health issues, and economic disparities affect the use and consistency of PrEP among gay men and other men who have sex with men (MSM), aiming to understand these complex interactions.
- - Analyzing data from the American Men's Internet Survey, researchers identified four different classes of sexual stigma and found that when combined with mental distress, these factors significantly lowered the likelihood of PrEP use and adherence.
- - The findings suggest a need for targeted interventions that consider these psychosocial factors to improve PrEP uptake and adherence among MSM, which can lead to better health outcomes.
Article Abstract
Background: Sexual 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.
Methods: Data 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.
Results: Four 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]).
Conclusions: Psychosocial 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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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611602 | PMC |
| http://dx.doi.org/10.1016/j.socscimed.2024.117493 | DOI Listing |
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