Women who inject drugs Social networks HIV Pre-exposure prophylaxis
Pre-exposure prophylaxis (PrEP) is a promising but underutilized HIV prevention strategy for Women who Inject Drugs (WWID). Stigma and disclosure concerns have been key barriers to PrEP use among women in PrEP efficacy trials. Social support has been found to buffer against some PrEP stigma, though these factors have been largely unexplored among WWID. Investigating how WWID disclose PrEP use is important given evidence that disclosure is associated with higher adherence. We aimed to identify the impact of stigma and support on PrEP disclosure within social networks of WWID participating in a PrEP demonstration project in Philadelphia, PA, USA. PrEP-using WWID ≥ 18 years completed social network surveys. Generalized estimating equations were used to account for the correlation of network structure. Thirty-nine WWID (i.e. egos) named an average of 9.5 ± 3.3 network members (i.e. alters), for a total sample of 371 unique relationships. Egos disclosed their PrEP use to an average of 4.0 alters (SD = 2.8). Related to PrEP stigma, participants had 0.4 times decreased odds of PrEP disclosure with alters who would disapprove of them taking PrEP (95% CI: 0.1-0.9). Related to support, participants had 2.5 times higher odds of disclosure among peers who could provide PrEP advice (95% CI: 1.0-6.0). Interventions that increase social support and decrease stigma are pivotal for increasing PrEP use disclosure among WWID.
The Influence of PrEP-Related Stigma and Social Support on PrEP-Use Disclosure among Women Who Inject Drugs and Social Network Members
Creators
Marisa Felsher - Division of Infectious Diseases, Johns Hopkins University School of Medicine, 4940 Eastern Ave, Baltimore, MD, 21224, USA. mfelshe1@jh.edu
Karley Dutra - Thomas Jefferson University Hospital
Brent Monseur - Stanford Health Care
Alexis M Roth - Johns Hopkins Medicine
Carl Latkin - Bloomberg
Oluwaseun Falade-Nwulia - Johns Hopkins Medicine
Publication Details
AIDS and behavior, v 25(12), pp 3922-3932
Publisher
Springer Nature
Grant note
R25HD079352 / NIH HHS
R21DA043417 / NIDA NIH HHS
Resource Type
Journal article
Language
English
Academic Unit
Infectious Diseases (and HIV Medicine); Community Health and Prevention
Web of Science ID
WOS:000652415700003
Scopus ID
2-s2.0-85106209514
Other Identifier
991019169577404721
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