Pre-exposure prophylaxis (PrEP) uptake has been extremely low among key groups. PrEP-related stigma and shaming are potential barriers to uptake and retention in PrEP programs. There is a lack of literature describing PrEP stigma. In order to fill this gap, we recruited online 43 HIV-negative Men who have Sex with Men (MSM) who use PrEP. Semistructured interviews were conducted to explore their perceptions and experience of stigma related to PrEP use. Data were analyzed using Strauss and Corbin’s grounded theory and constant comparison techniques to enhance understanding of the lived experiences of MSM who use PrEP. The participants experienced PrEP stigma as rejection by potential/actual partners, stereotypes of promiscuity or chemsex, and labeling of both the user and the medication. They connected PrEP stigma with HIV stigma, generational differences, moralization of condom use, and inability to embrace one’s own sexuality. These findings point to a need to develop tailored interventions to address PrEP-related stigma and shaming for individuals, health-care professionals, and the MSM community-at-large.
The lack of access to gender-affirming surgery represents a significant unmet healthcare need within transgender community frequently resulting in depression and self-destructive behavior. While some transgender people may have access to Gender Reassignment Surgery (GRS), an overwhelming majority cannot afford Facial Feminization Surgery (FFS). The former may be covered as a ‘medical necessity’, but FFS is considered ‘cosmetic’ and excluded from insurance coverage. This demarcation between ‘necessity’ and ‘cosmetic’ in transgender healthcare based on specific body parts is in direct opposition to the scientific community’s understanding of gender dysphoria and professional guidelines for transgender health. GRS affects one’s ability to function in intimate relationship while FFS has the same impact on social interactions and, therefore, may have a far greater implication for one’s quality of life. FFS is a cost-effective intervention that needs to be covered by insurance policies. The benefits of such coverage far exceed the insignificant costs.
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