Findings highlight the need for positive messaging targeting potential PrEP users and their social networks to increase PrEP acceptance and uptake.

Section 1 Diagnoses of HIV Infection and Diagnoses of Infection Classified as Stage 3 (AIDS) 1a Diagnoses of HIV infection, by year of diagnosis and selected characteristics, 2012-2017-United States 1b Diagnoses of HIV infection, by year of diagnosis and selected characteristics, 2012-2017-United States and 6 dependent areas 2a Stage 3 (AIDS), by year of diagnosis and selected characteristics, 2012-2017 and cumulative-United States 2b Stage 3 (AIDS), by year of diagnosis and selected characteristics, 2012-2017 and cumulative-United States and 6 dependent areas 3a Diagnoses of HIV infection, by race/ethnicity and selected characteristics, 2017-United States 3b Diagnoses of HIV infection, by race/ethnicity and selected characteristics, 2017-United States and 6 dependent areas 4a Stage 3 (AIDS), by race/ethnicity and selected characteristics, 2017-United States 4b Stage 3 (AIDS), by race/ethnicity and selected characteristics, 2017-United States and 6 dependent areas 5a Diagnoses of HIV infection among adults and adolescents, by year of diagnosis, sex, and selected characteristics, 2012-2017-United States 5b Diagnoses of HIV infection among adults and adolescents, by year of diagnosis, sex, and selected characteristics, 2012-2017-United States and 6 dependent areas 6a Stage 3 (AIDS) among adults and adolescents, by year of diagnosis, sex, and selected characteristics, 2012-2017-United States 6b Stage 3 (AIDS) among adults and adolescents, by year of diagnosis, sex, and selected characteristics, 2012-2017-United States and 6 dependent areas 7a Diagnoses of HIV infection attributed to male-to-male sexual contact and male-to-male sexual contact and injection drug use, by selected characteristics, 2012-2017-United States 7b Diagnoses of HIV infection attributed to male-to-male sexual contact and male-to-male sexual contact and injection drug use, by selected characteristics, 2012-2017-United States and 6 dependent areas 8a Diagnoses of HIV infection attributed to injection drug use, by selected characteristics, 2012-2017-United States 8b Diagnoses of HIV infection attributed to injection drug use, by selected characteristics, 2012-2017-United States and 6 dependent areas 9a Diagnoses of HIV infection attributed to heterosexual contact, by selected characteristics, 2012-2017-United States 9b Diagnoses of HIV infection attributed to heterosexual contact, by selected characteristics, 2012-2017-United States and 6 dependent areas 10a Stage 3 (AIDS) attributed to male-to-male sexual contact and male-to-male sexual contact and injection drug use, by selected characteristics, 2012-2017-United States 10b Stage 3 (AIDS) attributed to male-to-male sexual contact and male-to-male sexual contact and injection drug use, by selected characteristics, 2012-2017-United States and 6 dependent areas  HIV Surveillance Report 4 Vol. 29 15 Stage 3 (AIDS) among children aged <13 years, by year of diagnosis, 1992-2017-United States and 6 dependent areas 16 Diagnoses of HIV infection among adult and adolescent Hispanics/Latinos, by transmissio...

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Efforts to identify and address social inequities in HIV pre-exposure prophylaxis (PrEP) access are urgently needed. We investigated early-adopting PrEP prescribers' beliefs about how stigma contributes to PrEP access disparities in health care and explored potential intervention strategies within the context of PrEP service delivery. US-based PrEP prescribers were recruited through professional networks and participant referrals. Qualitative interviews were conducted, transcribed, and thematically analyzed. Participants (n = 18) were primarily male (72%); white (39%) or Asian (33%); and heterosexual (56%). Most practiced in the Northeastern (67%) or Southern (22%) United States; were physicians (94%); and specialized in HIV/infectious disease (89%). Participants described multiple forms of structural and interpersonal stigma impeding PrEP access. The requirement that PrEP be prescribed was a perceived deterrent for populations with medical mistrust and/or low health literacy. Practice norms such as discussing PrEP only in response to patient requests were seen as favoring more privileged groups. When probed about personally held biases, age-related stereotypes were the most readily acknowledged, including assumptions about older adults being sexually inactive and uncomfortable discussing sex. Participants criticized providers who chose not to prescribe PrEP within their clinical practice, particularly those whose decision reflected personal values related to condomless sex or discomfort communicating about sex with their patients. Suggested solutions included standardizing PrEP service delivery across patients and increasing cultural competence training. These early insights from a select sample of earlyadopting providers illuminate mechanisms through which stigma could compromise PrEP access for key populations and corresponding points of intervention within the health care system.

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