Sexual minority stressors (community homophobia, sexuality-related discrimination, and internalized homonegativity) are negatively associated with accessing HIV prevention services among men who have sex with men (MSM). Few studies have tested minority stressors’ associations with PrEP engagement among high-HIV risk young MSM (YMSM). Therefore, we assessed the associations between PrEP-indicated YMSM’s progression along the PrEP continuum and their experiences of minority stress. N = 229 YMSM completed a web-survey on PrEP-related behaviors and minority stress. Adjusted for covariates, we developed two partial-proportional odds models examining the associations between PrEP continuum progression and minority stressors, as a composite, and community homophobia, sexuality-related discrimination, and internalized homonegativity, respectively. Our multivariable model demonstrated minority stress levels to be negatively associated with PrEP continuum location (AOR = 0.76, 95% CI: 0.58–0.99). Broken down, discrimination was positively associated with reporting being at an advanced location along the continuum (AOR = 1.39, 95% CI: 1.06–1.82). Internalized homonegativity was negatively associated with continuum location between PrEP-aware participants with no intention to initiate and participants who intended to initiate PrEP (AOR = 0.45, 95% CI: 0.27–0.77) and between those who intended to initiate and those who had ever used PrEP (AOR = 0.39, 95% CI: 0.22–0.69). Our findings suggest that minority stress, especially internalized homonegativity, remains a barrier to PrEP among PrEP-indicated YMSM. Sexuality-related discrimination was associated with PrEP continuum progression, suggesting potentially well-developed, adaptive coping skills (e.g., ability to locate sexuality-affirming providers). Coupled with stigma reduction efforts, HIV prevention services aiming to promote PrEP should incorporate internalized homonegativity screenings and referrals into sexuality-affirming resources for PrEP-indicated YMSM.

性少数群体压力源（社区同性恋恐惧症，与性相关的歧视和内在的同性消极）与获得性行为的男性中获得艾滋病毒预防服务呈负相关。很少有研究测试高HIV感染风险的年轻MSM（YMSM）中少数压力源与PrEP参与的关系。因此，我们评估了PrEP指示的YMSM沿PrEP连续体的进展与其少数民族压力经历之间的关联。ñ = 229 YMSM完成了有关PrEP相关行为和少数群体压力的网络调查。调整协变量后，我们开发了两个部分比例的赔率模型，分别检查了PrEP连续谱进程与少数群体压力源之间的关联，以及社区同性恋恐惧症，与性相关的歧视和内在的同质性。我们的多变量模型表明少数压力水平与PrEP连续体位置呈负相关（AOR  = 0.76，95％CI：0.58–0.99）。细分而言，歧视与报告在连续体的高级位置呈正相关（AOR = 1.39，95％CI：1.06-1.82）。内在同向性与无意识发起PrEP的参与者和有意发起PrEP的参与者之间的连续体位置呈负相关（AOR  = 0.45，95％CI：0.27–0.77）以及有意发起和未曾有过的参与者之间二手PrEP（AOR = 0.39，95％CI：0.22-0.69）。我们的发现表明，在PrEP指示的YMSM中，少数群体的压力，尤其是内在的负性，仍然是PrEP的障碍。与性相关的歧视与PrEP连续性发展有关，提示潜在的发达的适应性应对技能（例如，能够确定性的提供者的能力）。与减少耻辱感的努力相结合，旨在促进PrEP的HIV预防服务应将内部同性阴性筛查和转诊纳入确认PrMS所指YMSM的性确认资源中。