WED-040 - Associations Between Structural Barriers, Attitudes, Willingness, and Stigma Towards Prep in LGBTQ+ People of Color

Brief Abstract Summary: Learn about the relationship between barriers, attitudes, willingness, and stigma towards PrEP among LGBTQ+ People of Color (PoC). Pre-exposure prophylaxis (PrEP) is a clinically proven medication that reduces HIV risk, yet prior research has identified barriers to PrEP uptake among Black and Hispanic/Latinx sexual minority men and transgender women, such as internalized social stigma and logistical obstacles (Watson et al., 2022). This quantitative study exclusively included self-reported LGBTQ+ PoC (N = 439), aged 18-66, majority Latina/o/x and Black/African American persons, who were seronegative (n = 406) or seropositive (n = 33). Results showed that fewer barriers to PrEP were linked to more positive attitudes toward its use and a greater willingness to take it, but they were not linked to levels of PrEP stigma. These findings point to the need for health policies that address structural barriers faced by LGBTQ+ PoC, who may struggle to access PrEP medication.

Detailed abstract description: Attendees will gain awareness into how structural barriers, attitudes, willingness, and stigma influence PrEP use among LGBTQ+ PoC, while becoming advocates for policies and health initiatives that protect HIV preventative care access. In the current U.S. sociopolitical climate, where anti-LGBTQ+ policies are rising, social stigma and health challenges increase for LGBTQ+ populations, and access to care and resources diminishes (Tran & Gonzales, 2025). The intersection of sexual orientation, gender identity, and race shapes the unique experiences and needs of LGBTQ+ PoC (Choi, Wilson, & Mallory, 2021). Racial and ethnic disparities persist in HIV diagnoses among U.S. gay and bisexual men, who accounted for 70% of new cases in 2022, and transgender women, who comprised 2% of new cases in 2019, with most cases among Black/African American or Hispanic/Latino populations (Centers for Disease Control and Prevention, 2024). Attendees will be exposed to our study focused on LGBTQ+ People of Color who reported PrEP-related barriers, attitudes, and stigma that impacted their willingness to use PrEP medication. Participants were recruited from the online platform Amazon Mechanical Turk (MTurk) in December 2018. We measured barriers to PrEP (Gersh et al., 2014; Mimiaga et al., 2009), as well as attitudes toward PrEP (Mustanski et al., 2018), including positive attitudes and perceptions of PrEP stigma, and willingness to use PrEP (Gersh et al., 2014; Mimiaga et al., 2009). We conducted three separate regression analyses to examine the associations of barriers with stigma, positive attitudes, and willingness to take PrEP. Results showed that lower PrEP barriers were positively associated with PrEP positive attitudes (B = 0.75, p <.001, R2= .25), while lower PrEP barriers were not significantly associated with PrEP stigma (B = -0.01, p = .955), and instead were positively associated with willingness to take PrEP (B = 0.67, p = <.001, R2 = .31). These findings suggest that having fewer structural barriers is associated with health-promoting attitudes, including more positive attitudes towards PrEP and willingness to take PrEP. Together, these results highlight the urgent need for health promotion initiatives that encourage PrEP use and call for public health policies that address structural barriers limiting access among LGBTQ+ PoC populations. Policy and county-level programs that expand PrEP access, such as Medicaid and Drug Assistance Programs, are associated with 99% higher PrEP uptake (Siegler et al., 2020), demonstrating the impact of using evidence-based research to increase structural interventions that reduce HIV-related disparities and support disadvantaged communities. Thus, attendees will gain a clear understanding of why PrEP-related structural barriers and social stigma must be addressed, as well as how research can inform public health policy and program design.