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Why Fighting HIV Stigma and PrEP Stigma Is Basically the Same

Tags: PrEP, HIV stigma


The use of Truvada as PrEP can protect individuals against HIV 99 percent of the time if taken correctly. The HIV prevention pill is now deemed as safe as Asprin, according to a study released three weeks ago. Truvada is also covered by most health care providers as well as Medicaid. So if the drug that could prevent a chronic disease is effective, safe, and affordable, why aren't more men choosing to take it even though rate of HIV infection still on the rise?

It’s not just the fact that gay men have not heard about the drug. In one study, 79 percent of gay men knew about Truvada, but only 11 percent had tried it. Although we still need more education surrounding Truvada, there are other factors at play besides ignorance about the drug’s existence. One underlying problem is that there still remains a stigma surrounding both HIV and PrEP.

In an opinion column published in the Washington Post, writer Richard Morgan largely blames Gay rights groups for the drug’s lack of popularity. He writes, “Gay rights groups are largely to blame. Rather than educating men about Truvada, they’ve focused on stamping out the stigma around HIV.”

Yet, in his attack of gay rights groups, he misses a key point: the stigma surrounding HIV is very much related to the stigma surrounding Truvada. Many young gay men do not want to believe that HIV is their problem and are very much in denial about the disease.

If you go against that consensus and do believe that HIV is an issue and decide to take PrEP, some gay men see you as sexually reckless, slutty, and a whore.

In a clinical trial, 78 percent of men who did qualify to use PrEP based on their sexual history did not believe that their risk was sufficient enough to start taking the drug. Basically, rather than looking at Truvada as the smart option, they thought that that only risky and careless men would start taking Truvada and they didn’t think of themselves as that kind of person. No one really wants to be that guy. Some men also think that Truvada will increase risky sexual behavior, which is again another misconception. Study after study shows that men who start using Truvada don't actually turn into voracious sluts over night. They really don’t change their sexual habits. The truth is that some guys still don’t want to admit that they may accidently or purposely have sex with an HIV-positive man due to the stigma surrounding HIV. Women who go on birth control to prevent pregnancy aren’t labeled slutty or sexually reckless, but why then are men who start to take Truvada? Largely because a straight woman who gets pregnant by accident just does not have the same stigma as a gay man who contracts HIV.

You have to first think about HIV as a problem in order to start thinking about HIV protection. The truth of the matter is that stigma surrounding HIV is so much engrained in popular culture, that most men just do not want to think about HIV as an issue. By focusing on stamping out the stigma of HIV and drawing attention to the disease, gay rights groups are helping start a conversation about Truvada.

The stigma surrounding HIV in the medical community also prevents men from getting tested and talking to their health care providers about prevention methods. This is especially true among African American men. In a study published by the American journal of public health, 29 percent of black men reported experiencing sexual orientation discrimination by their health care providers and 48 percent reported an overall mistrust in the medical community. If many men do not feel comfortable getting tested or talking about prevention options, then it shouldn’t come as a surprise that gay black men are 72 percent more likely to contract HIV than the general population.

Morgan is also wrong when he suggests that gay rights groups aren’t concerned with educating men about Truvada and that they “tiptoe around strategies for prevention.” Many groups are concerned about the stigma surrounding PrEp emanating from both HIV-negative men as well as HIV survivors. The social media movement of #Truvadawhores, started in 2014 by Adam Zeboski, is just one example of the way that activists groups have tried to start a conversation about the negative stigma surrounding Truvada.

Morgan belittles activists who focus on accepting those who are infected, “Of sharing stories and cloying hashtag slacktivism. Rather than trying to destigmatize Truvada, in other words, they’re destigmatizing HIV.” Yet he misses the point that the stigmatization surrounding HIV is the root of the stigmatization surrounding Truvada and other PrEp treatments. What’s more, in his attack, he does a disservice to the community by creating division and divisiveness rather than applauding activists who are really all on the same side.