BACKGROUND: Pre-exposure prophylaxis (PrEP) significantly reduces the risk of contracting HIV among all individuals. The success of PrEP has led to the development of targeted health campaigns for encouraging the uptake of PrEP among sexual and gender diverse communities, who account for some of the highest HIV transmission rates in the U.S. PrEP uptake among Black sexual and gender-diverse populations (BSGD) remains low, which is worrisome given that BSGD populations have an elevated risk of HIV seroconversion. Scholars have investigated psychosocial barriers to PrEP uptake in BSGD populations, but little is known about positive and promotive factors associated with PrEP use.
METHOD: Leveraging baseline data from an ongoing longitudinal PrEP study (N = 380), the current study investigated what factors may be associated with lifetime use and current use of PrEP in BSGD populations. We used a cross-sectional design to examine the associations between psychosocial barriers (i.e., HIV microaggression, PrEP stereotypes, and PrEP stigma) and positive promotive factors (i.e., resiliency, sex positivity, and social support) among two outcome variables, current and lifetime use of PrEP.
RESULTS: Using binary logistic regression models, we found that sex positivity was strongly positively associated with both lifetime and current PrEP use, and HIV microaggressions were negatively associated with current PrEP use.
CONCLUSION: Our findings indicate that sex positivity may be an important strengths-based factor related to PrEP use. HIV prevention strategies should consider including sex-positive messaging to increase PrEP usage and bolster sexual empowerment in BSGD populations in order to dismantle HIV and PrEP stigmas.
Sex positivity, resilience, social support, and PrEP and HIV stigmas: Associations with current and lifetime use of PrEP
International Journal of Sexual Health [Epub 2025 Nov 17]. doi: 10.1080/19317611.2025.2587107.