Drug and alcohol dependence
September 19, 2026 · via Europe PMC
PrEP stigma and early oral PrEP care continuum outcomes among people who inject drugs in Los Angeles and Denver.
Khezri M, Ivasiy R, Rahman F, +6 more, Walters SM.
AI summary — for doctors, generated from the abstract only
Higher PrEP stigma was linked to lower willingness to take PrEP among people who inject drugs.
What was studied
Survey of 243 HIV-negative PWID in Los Angeles and Denver.
Key findings
- 63% had heard of PrEP, 46.2% willing, 5.0% attempted access
- Stigma not associated with awareness
- Each point of stigma reduced willingness odds by 78% (aOR 0.22)
Clinical relevance
Highlights stigma reduction for PrEP uptake.
Who should care
Limitations
Cross-sectional with a small sample and few attempts.
Address stigma when offering PrEP.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Despite high HIV risk among people who inject drugs (PWID), uptake of pre-exposure prophylaxis (PrEP) remains low. Understanding the role of stigma toward PrEP use among PWID can inform interventions to improve engagement along the PrEP care continuum. We examined associations between PrEP stigma and early PrEP care continuum steps: awareness, willingness to take PrEP, and attempts to access PrEP, among PWID.
Methods
We analyzed data from 243 HIV-negative PWID recruited through community-based and peer outreach efforts in Los Angeles, California, and Denver, Colorado, between April 2021 and June 2023. Participants completed a survey assessing stigma toward PrEP, awareness of PrEP, willingness to take PrEP, and attempts to access PrEP, along with sociodemographic and behavioral factors. This study refers specifically to oral PrEP, the predominant formulation available during the study period. A 10-item PrEP stigma scale assessed attitudes and perceptions toward PrEP use. Stigma items were averaged to create a continuous score (range 0-4). Multivariable logistic regression models estimated associations between PrEP stigma and each PrEP care continuum outcome.
Results
Overall PrEP stigma was relatively low (mean = 1.64, SD = 0.46). Sixty-three percent of participants had heard of PrEP, 46.2% reported willingness to take PrEP, and 5.0% had attempted to access PrEP. PrEP stigma was not associated with awareness of PrEP (aOR = 0.89; 95% CI: 0.46, 1.70). However, higher stigma was significantly associated with lower willingness to take PrEP; each one-point increase in stigma score was associated with 78% lower odds of willingness (aOR = 0.22; 95% CI: 0.10, 0.48). Higher stigma was also associated with lower odds of attempting to access PrEP in unadjusted analyses (OR = 0.15; 95% CI: 0.04, 0.62), but this association was not statistically significant after adjustment (aOR = 0.10; 95% CI: 0.01, 1.05).
Conclusion
Stigma toward PrEP, reflected in negative beliefs and social attitudes about PrEP use, remains an important barrier to willingness to initiate PrEP among PWID. Interventions addressing PrEP-related stigma may improve PrEP engagement and help reduce HIV transmission risk among PWID.
DOI
10.1016/j.drugalcdep.2026.113371
PMID
42822173
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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