PrEP-related stigma and PrEP use among gay, bisexual and other men who have sex with men in Ontario and British Columbia, Canada

AIDS Res Ther. 2022 Oct 27;19(1):49. doi: 10.1186/s12981-022-00473-0.


Background: We aimed to explore the association between PrEP-related stereotypes and perceived disapproval (hereafter PrEP-related stigma), and PrEP use.

Methods: We used data from a cross-sectional online survey among adult gay, bisexual, other men who have sex with men in Ontario and British Columbia, Canada. Participants were recruited 2019-2020 in-person from sexual health clinics and outreach programs, and online through dating mobile applications and websites. We used logistic regression models to explore the relationship between PrEP-related stigma and: 1-being a 'never' versus 'current' PrEP user, and 2-being a 'former' versus 'current' user.

Results: The median age of the sample was 32 (Q1-Q3 = 27-40), most were white born in Canada (48%), 45% had never used PrEP, 16% were former PrEP users and 39% were current PrEP users. Of 1527 individuals who started the survey, 1190 participants answered questions about PrEP-related stigma: 254 (21.3%) were classified as having low level of PrEP-related stigma, 776 (65.2%) intermediate, and 160 (13.5%) high. No significant association was found when never PrEP users and current PrEP users were compared: adjusted OR = 1.44 (95%-CI: 0.8-2.5). High PrEP-related stigma was positively associated with being a former PrEP user compared to being a current PrEP user: adjusted OR = 2.5 (95%-CI: 1.3-4.9).

Conclusion: PrEP-related stigma is associated with not using PrEP, particularly with PrEP discontinuation. Our findings indicate that stigma persists as a barrier to PrEP use.

Keywords: HIV pre-exposure prophylaxis; Health promotion; Health services accessibility; Retention in care; Social stigma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • British Columbia
  • Cross-Sectional Studies
  • HIV Infections* / prevention & control
  • Homosexuality, Male
  • Humans
  • Male
  • Ontario
  • Pre-Exposure Prophylaxis*
  • Sexual Behavior
  • Sexual and Gender Minorities*