Intersectional stigma associations with long-acting injectable PrEP (LAI-PrEP) willingness and preference among cisgender gay, bisexual, and other men who have sex with men (GBMSM): A brief quantitative report

Authors

• Jennifer L. Glick, LSU Health Sciences Center - New OrleansFollow
• Danielle F. Nestadt, Johns Hopkins University, Baltimore, MD
• Travis Sanchez, Emory University, Atlanta, GA
• Irah L. Lucas, Emory University, Atlanta, GA
• Mariah Valentine-Graves, Emory University, Atlanta, GA
• Thomas Carpino, Johns Hopkins University, Baltimore, MD
• Duygu Islek, Emory University, Atlanta, GA
• Kaitlyn Atkins, Johns Hopkins University, Baltimore, MD
• Sarah M. Murray, Johns Hopkins University, Baltimore, MD
• Stefan Baral, Johns Hopkins University, Baltimore, MD
• Supriya Sarkar, ViiV Healthcare, Durham, NC
• Leigh Ragone, ViiV Healthcare, Durham, NC
• Vani Vannappagari, ViiV Healthcare, Durham, NC

Document Type

Article

Publication Date

2-12-2026

Publication Title

Journal of Acquired Immune Deficiency Syndrome

Abstract

Background: – Gay, bisexual, and other men who have sex with men (GBMSM) in the United States (U.S.) are disproportionately impacted by the HIV epidemic. Long-acting injectable pre-exposure prophylaxis (LAI-PrEP) represents a novel HIV prevention strategy. However, stigma remains a barrier to HIV-related prevention and care. We investigated the role of intersectional stigma in LAI-PrEP preferences among past-year PrEP naïve, HIV-negative U.S. cisgender GBMSM.Methods: – The 2022 American Men’s Internet Survey (AMIS) enrolled cisgender GBMSM online between October 2022 and October 2023. Using bivariate and multivariable adjusted Poisson regression with robust variance and a modified Intersectional Discrimination Index to examine associations between several forms of stigma—anticipated, day-to-day, social systems exclusion, and violence and harassment—and LAI-PrEP willingness and preference.Results: – Among participants (N=1196), 705 (59.0%) were willing to use any PrEP modality and 393 (32.9%) were willing to use LAI-PrEP, among whom 211 (29.9%) reported a preference for LAI-PrEP. On average, participants experienced 1.8 of 7 anticipated discrimination items, 3.9 of 7 day-to-day discrimination items, 0.2 of 3 social systems exclusion items, and 0.9 of 4 violence/harassment items. Willingness to use LAI-PrEP was associated with anticipated stigma (aPR=1.06; 95% CI=1.02-1.10; p < 0.01). Preference for LAI-PrEP was associated with anticipated stigma (aPR=1.06; 95% CI=1.00-1.12; p=0.04), day-to-day (aPR=1.09; 95% CI=1.02-1.15; p=0.01) stigma, and violence/harassment (aPR=1.09; 95% CI=1.01-1.18; p-0.03).Conclusions: – Given disproportionate HIV burden among GBMSM, a range of HIV PrEP modality options combined with efforts to address intersectional anticipated and enacted stigma among GBMSM is critical to ensure PrEP access, uptake, and adherence.

PubMed ID

41677106

Rights

Copyright © 2026 Wolters Kluwer Health, Inc.

Recommended Citation

Glick, Jennifer L.; Nestadt, Danielle F.; Sanchez, Travis; Lucas, Irah L.; Valentine-Graves, Mariah; Carpino, Thomas; Islek, Duygu; Atkins, Kaitlyn; Murray, Sarah M.; Baral, Stefan; Sarkar, Supriya; Ragone, Leigh; and Vannappagari, Vani, "Intersectional stigma associations with long-acting injectable PrEP (LAI-PrEP) willingness and preference among cisgender gay, bisexual, and other men who have sex with men (GBMSM): A brief quantitative report" (2026). School of Public Health Faculty Publications. 560.
https://digitalscholar.lsuhsc.edu/soph_facpubs/560
10.1097/QAI.0000000000003850