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Intersectional Discrimination and Preferences for Long-acting Injectable HIV PrEP among Gay, Bisexual, and Men Who have Sex with Men in Philadelphia by Ethnoracial Groups: A Cross-Sectional Study
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Intersectional Discrimination and Preferences for Long-acting Injectable HIV PrEP among Gay, Bisexual, and Men Who have Sex with Men in Philadelphia by Ethnoracial Groups: A Cross-Sectional Study

Nguyen K. Tran, Neal D. Goldstein, Ayden I. Scheim, Omar Martinez, Riana Tuwaidan and Seth L. Welles
Sexuality research & social policy, Forthcoming
04 Aug 2026
DOI: https://doi.org/10.1007/s13178-026-01398-3
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Abstract

HIV Long-acting injectablel pre-exposure prophylaxis Intersectional discrimination Cisgender gay and bisexual men, men who have sex with men
Introduction Black and Latino gay, bisexual, and men who have sex with men (GBM) continue to face higher rates of HIV compared to White GBM. Intersectional discrimination is an important barrier to oral pre-exposure prophylaxis (PrEP) uptake, but its association with long-acting injectable (LAI) PrEP preferences remains understudied. Methods We conducted a cross-sectional study of 433 cisgender GBM in Philadelphia between June 2021 to March 2022. Using logistic regression with marginal standardization, we examined associations between intersectional discrimination and LAI PrEP preferences, testing effect modification by ethnoracial group. Results Preference for LAI PrEP over daily oral (76%) or on-demand PrEP (64%) was high. In adjusted models, compared to the lowest quartile, men in the highest quartile of anticipated discrimination were more likely to prefer LAI PrEP over daily oral (aPR = 1.21, 95% CI = 1.04, 1.41) and on-demand PrEP (aPR = 1.43, 95% CI = 1.21, 1.70). Those in the highest quartile of day-to-day discrimination were more likely to prefer LAI PrEP over on-demand PrEP (aPR = 1.32, 95% CI = 1.10, 1.59). Conversely, those in higher quartiles of major discrimination had lower prevalence of preferring LAI PrEP over daily oral PrEP (aPRs = 0.85 and 0.84). Limited evidence of effect modification by ethnoracial group was observed. Conclusion Findings suggest a greater preference for LAI PrEP over both oral formulations and highlight the complex relationship between intersectional discrimination and PrEP modality preferences.

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