Australian Federation of AIDS Organisations

Pride, prejudice and... PrEPPride, prejudice and... PrEP: : appraising the impact of new appraising the impact of new

prevention technologiesprevention technologies

Dean MurphyDean Murphy

AFAO HIV Educators’ Conference 2010AFAO HIV Educators’ Conference 2010

BackgroundBackground

• By the end of 2010, results of some clinical trials By the end of 2010, results of some clinical trials of HIV pre-exposure prophylaxis (PrEP) will be of HIV pre-exposure prophylaxis (PrEP) will be released.released.

• This presentation: This presentation: – PrEP trialsPrEP trials– HIV-related stigma and discriminationHIV-related stigma and discrimination– Possible impacts of PrEP Possible impacts of PrEP

Current PrEP trials: whenCurrent PrEP trials: when

Current PrEP trials: what; whoCurrent PrEP trials: what; who

Current PrEP trials: whereCurrent PrEP trials: where

Expectations

• We don’t know much about expectations of PrEP among gay men & MSM

• PrEP study by MSM Global Forum is starting now

• In US, low levels of awareness of PrEP among gay and bisexual men, and very low levels of non-prescribed use

• However, high acceptability if efficacious

HIV-related stigma and HIV-related stigma and discriminationdiscrimination

• Experience of stigma associated with:– More social engagement with other PLHIV– Greater importance of own serostatus identity– [Not associated with having HIV-negative or status

unknown regular or casual partners]

• Expression of stigma associated with:– Less social engagement with PLHIV and gay men– More perceived HIV transmission risk– Greater importance of own serostatus identity– [Not associated with having HIV-positive regular or

casual partners]

PrEP and increased HIV-related stigma?

• Attitudes towards people who seroconvert in the post-PrEP era

• PrEP ‘failures’ (i.e. viral breakthrough)• Disclosure (e.g. for seroodiscordant couples)• Responsibility/criminalisation• Access• Designation of new risk groups (who are

recommended for PrEP)• Resources

PrEP and decreased HIV-related stigma?

• Reduced HIV transmission risk • More serodiscordant relationships• Less stigmatising attitude towards HIV in general • Serostatus identity?• Re-engagement with HIV prevention

• New risk reduction strategies?

Keeping up to date…Keeping up to date…

• AIDS Vaccine Advocacy Coalition (AVAC)AIDS Vaccine Advocacy Coalition (AVAC)– http://www.avac.org (This site has replaced prepwatch.org)http://www.avac.org (This site has replaced prepwatch.org)

• Community HIV/AIDS Mobilization Project (CHAMP)Community HIV/AIDS Mobilization Project (CHAMP)– http://www.champnetwork.org/iprep-research-agendahttp://www.champnetwork.org/iprep-research-agenda

• AFAOAFAO– http://www.afao.org.au/http://www.afao.org.au/

• National Institutes of HealthNational Institutes of Health– http://clinicaltrials.gov/