Table 3.

PrEP-related stigma documented in scoping review by stigma dimension and thematic findings

Stigma dimension	Examples
Experienced stigma	“One of my partners was like, ‘Whoa, whoa. What does this mean? What are you doing?’ In other words, indicating that just by taking the pill this means that I’m willy-nilly having unprotected sex.”
	“If doctors make me uncomfortable for being gay, then the last thing I want to do is tell you about my sex life … There are a lot of doctors who throw their own personal opinion into their perspective. One asked me if I’m homosexual. That made me uncomfortable.”
Enacted stigma	“For me, if someone just said so-and-so’s using PrEP and I knew what PrEP was at that time, I would question what is their HIV status… [Or] they could just be very—really promiscuous.”
	“I feel like the only people that really need it is if you’re in a relationship, you’re negative and your partner is positive. That’s the only reason why I feel like you should be taking PrEP. Other than that, it’s just an excuse to slut around.”
Perceived stigma	“The idea is that if you go on PrEP, you are like very wanton and want to be barebacking all the time and that you are not safe. In other words, you are one of those petri dish people.”
Anticipated stigma	“I keep my medication in my room and not in the bathroom where I used to keep it because either my little brother or my mom might see it and they’d be like, ‘Hmm, why is this person taking this?’ Maybe they’ll assume that I have HIV.”
Internalized stigma	“I know I still work hard at not letting my own freedom of sexual expression and identity feel like anything but healthy and positive. I know that PrEP for me means embracing and owning that ‘I made it’ despite the risks … There’s a bit of ‘survivor guilt’… All of that gets put in the mix when it comes to the shaming.”
	“The shaming comes from fear and the majority of the stigma is within the LGBT community … Within the LGBT community, there is a lot of internalized homophobia attached to PrEP and these people are afraid of having the sex they want. That is attached to shaming as well.”
	“If somebody knew I was asking about that pill. Then there is a stigma that goes along with that. And I think that people will obviously look at you differently…”
Challenging stigma	“I feel like if they’re [on PrEP], they’re not only protecting themselves. It’s also for the well-being of other people that they’re having sex with. I don’t think there’s anything bad. I think it’s all positive.”
	“I post about it all the time. People filter their stuff to me, as well. There was a moment there when I feel like I was answering PrEP questions daily with gays that I know that were like, ‘Tell me about PrEP,’ or, ‘I don’t know about it.’ Now people share new stories about PrEP with me.”
	“Because everybody needs to know about it. There’s a few things. I am trying to abolish stigma around sexuality. I am trying to raise awareness for sexual health and the people who follow me are not just homosexuals, so the more times I can interact with just one heterosexual person, or 10 or 50 or 100, and be like, ‘Hey, there’s a medicine. Go talk to your doctor about it. It’s like birth control for HIV.’”