How current and potential pre-exposure prophylaxis (PrEP) users experience, negotiate and manage stigma: disclosures and backstage processes in online discourse

Research on stigma as a barrier to pre-exposure prophylaxis (PrEP) uptake for reducing risk of HIV infection has focused on the experience of stigma-othering, shaming and blaming and the associated negative social consequences of this stigmatisation. This study expands this focus to examine how current and potential users of PrEP discuss their experiences of stigmatisation, in addition to their anticipation, preparation and management of stigmatising encounters. The corpus of testimonial blog posts from the "My PrEP Experience" website, reader comments on those posts, and information available through hyperlinks in the posts and comments, were subjected to a qualitative textual analysis. Findings revealed stigmatising labels and perceptions identified in other PrEP and HIV-related stigma research. Findings also revealed the active seeking and sharing of strategies for coping with and challenging stigma, including the creative re-appropriation of negative labels and calls for advocacy. The discussion considers how the described preparation and management strategies can inform future efforts to reduce stigma and encourage PrEP uptake.