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How stigma surrounding the use of HIV preexposure prophylaxis undermines prevention and pleasure: A call to destigmatize "truvada whores"

Author

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  • Calabrese, S.K.
  • Underhill, K.

Abstract

Antiretroviral preexposure prophylaxis (PrEP; emtricitabine and tenofovir disoproxil fumarate [Truvada]) prevents HIV without penalizing sexual pleasure, and may even enhance pleasure (e.g., by reducing HIV-relatedanxiety). However, concern about sexual risk behavior increasing with PrEP use (risk compensation) and corresponding stereotypes of promiscuity may undermine PrEP's preventive potential. In this commentary, we review literature on sexual behavior change accompanying PrEP use, discuss risk compensation concerns and the "Truvadawhore" stereotype as PrEP barriers, question the appropriateness of restricting PrEP access because of risk compensation, and consider sexual pleasure as a benefit of PrEP,an acceptable motive for seeking PrEP, and a core element of health. It is essential for science to trump stereotypes and sexnegative messaging in guiding decision-making affecting PrEP access and uptake.

Suggested Citation

  • Calabrese, S.K. & Underhill, K., 2015. "How stigma surrounding the use of HIV preexposure prophylaxis undermines prevention and pleasure: A call to destigmatize "truvada whores"," American Journal of Public Health, American Public Health Association, vol. 105(10), pages 1960-1964.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2015.302816_0
    DOI: 10.2105/AJPH.2015.302816
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    Cited by:

    1. Jeff Lane & Audrey Brezak & Pragna Patel & Andre R. Verani & Irene Benech & Aaron Katz, 2021. "Policy considerations for scaling up access to HIV pre‐exposure prophylaxis for adolescent girls and young women: Examples from Kenya, South Africa, and Uganda," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(5), pages 1789-1808, September.
    2. Felsher, Marisa & Ziegler, Eliza & Amico, K. Rivet & Carrico, Adam & Coleman, Jennie & Roth, Alexis M., 2021. "“PrEP just isn't my priority”: Adherence challenges among women who inject drugs participating in a pre-exposure prophylaxis (PrEP) demonstration project in Philadelphia, PA USA," Social Science & Medicine, Elsevier, vol. 275(C).
    3. Ian W Holloway & Evan A Krueger & Ilan H Meyer & Marguerita Lightfoot & David M Frost & Phillip L Hammack, 2020. "Longitudinal trends in PrEP familiarity, attitudes, use and discontinuation among a national probability sample of gay and bisexual men, 2016–2018," PLOS ONE, Public Library of Science, vol. 15(12), pages 1-13, December.

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