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NIH grant 1R03NR022593-01A1: Combined Effects of PrEP and HIV Stigma on PrEP Adherence: Psychosocial Pathways among Youth at Risk for HIV
Institute: {'code': 'NR', 'abbreviation': 'NINR', 'name': 'National Institute of Nursing Research', 'admin_org_id': '12500052', 'admin_funding_url': ''}. PI: Ibrahim Yigit. Award: $154000.
Start: 2026-09-25T00:00:00.
Project Summary/Abstract
Despite the availability of effective HIV pre-exposure prophylaxis (PrEP), PrEP uptake and adherence remain
suboptimal, particularly among youth at high risk of HIV infection. Existing evidence highlights that stigma—both
PrEP-related stigma (e.g., being judged for using PrEP due to assumptions about HIV risk or status) and
anticipated HIV stigma (e.g., being perceived as HIV-positive)—serves as a critical barrier, undermining
adherence and increasing vulnerability to HIV in this group. These forms of stigma are hypothesized to interact
and compound, worsening adherence and health outcomes. Drawing on baseline data from the Prepared,
Protected, emPowered (P3) randomized-controlled trial among youth (N=235) in the United States, this research
will examine: 1) the relationships between co-occurring stigma profiles (i.e., the combined effects of PrEP stigma
dimensions—enacted stigma, perceived community stigma, user stereotypes, and disapproval by others—and
anticipated HIV stigma) and adherence, as measured by self-report and dried blood spots; and 2) potential
mediators (PrEP confidence, PrEP difficulties, perceived HIV risk, and social support) in these relationships.
Using latent profile analysis (LPA), we will first identify PrEP and anticipated HIV stigma profiles and then assess
their impact on PrEP adherence measures. Furthermore, we will test mediation models, where stigma profiles
are associated with mediator variables, which subsequently relate to adherence outcomes. Findings are
expected to reveal distinct profiles of multiple stigmas that hinder PrEP adherence and to highlight key
psychosocial pathways contributing to these outcomes. This study will also contribute to the design of targeted,
stigma-reduction interventions that address complex, co-occurring stigmas among youth, offering scalable
strategies to improve adherence and reduce HIV disparities. This research will provide foundational insights for
a larger R01 study aimed at improving PrEP engagement and health outcomes in stigmatized, high-risk
populations.document fetched 2026-10-04 02:43