Societal Challenges Keep At-risk Individuals from Taking PrEP

Kenneth Mayer, MD, Medical Research Director, Professor of Medicine, Fenway Health, Harvard University, discusses some societal challenges that at-risk individuals face today that may keep them from taking pre-exposure prophylaxis.

Interview Transcript (slightly modified for readability):

“PrEP has to be seen in the larger context of how we, as a society, deal with HIV. There are a couple of things that are relevant in the current era. Some people at risk for HIV and some providers just don’t think HIV is a big deal anymore because it’s invisible and in the bad old days, you could tell if somebody was HIV-infected very often. They’d be wasted; they might have skin lesions of Kaposi’s sarcoma. We don’t have that anymore because we have effective medication. And so, for some people it’s not on the radar, and even if they’re at high risk, it’s not something they think about.

For a lot of other people, HIV still is associated with a lot of stigmas. Some parts of society still reject homosexuality; some parts of society have concerns about injecting drug users. Among heterosexuals, we know that HIV is more prevalent in the black community and there may be stigma associated with the presumption that a woman or a man who is HIV-infected is highly sexually active. To take PrEP means that you have to say, ‘I’m at risk for developing this infection that puts me in one of these categories that I might be judged by my providers. I may be judged by my friends, my family.'”

And so, we still have to broaden the conversation. PrEP is not a magic bullet that solves all the problems—that’s for sure.”