HIV remains a public health concern in the United States. Although pre-exposure prophylaxis (PrEP) can be expected to reduce HIV incidence, its uptake, adherence, and persistence remain limited, particularly among highest priority groups such as men who have sex with men and transwomen (MSMTW). Using a socioecological framework, we conducted a scoping review to examine PrEP-related stigma to inform future research, policy, and programmatic planning. Using the PRISMA extension for scoping reviews, we conducted database searches from August 2018 to April 2020 for articles addressing PrEP stigma. Studies were independently screened and coded by three authors, resulting in thematic categorization of several types of PrEP stigma on four socioecological levels. Of 557 references, a final sample of 23 studies was coded, 61% qualitative, and 87% focusing exclusively on MSMTW. Most instances of PrEP-related stigma occurred on the interpersonal level and included associations of PrEP with risk promotion, HIV-related stigma, and promiscuity. Other frequent themes across socioecological levels included provider distrust and discrimination, government and pharmaceutical industry distrust, internalized homonegativity, PrEP efficacy distrust, and anticipated homonegativity. Notably, PrEP was also framed positively as having physical and psychological benefits, and assuming responsibility for protecting one’s community via PrEP awareness-raising. PrEP-related stigma persists, demanding interventions to modify its impact. Leveraging PrEP-positive discourses to challenge PrEP stigma is an emerging avenue, alongside efforts to increase provider willingness to promote PrEP routinely by reducing provider bias, aligning with the national strategy to End the HIV Epidemic.

艾滋病毒仍然是美国的一个公共卫生问题。尽管暴露前预防 (PrEP) 有望降低艾滋病毒发病率，但其吸收、依从性和持久性仍然有限，特别是在男男性行为者和变性女性 (MSMTW) 等最优先群体中。我们利用社会生态学框架进行了范围界定审查，以检查与 PrEP 相关的耻辱感，为未来的研究、政策和规划规划提供信息。我们使用 PRISMA 扩展进行范围审查，从 2018 年 8 月到 2020 年 4 月进行数据库搜索，寻找解决 PrEP 耻辱问题的文章。研究由三位作者独立筛选和编码，从而在四个社会生态学层面对几种类型的 PrEP 耻辱进行了主题分类。在 557 份参考文献中，对 23 项研究的最终样本进行了编码，其中 61% 是定性研究，87% 专门关注 MSMTW。大多数与 PrEP 相关的耻辱发生在人际层面，包括将 PrEP 与风险提升、艾滋病毒相关耻辱和乱交联系在一起。社会生态层面的其他常见主题包括医疗服务提供者不信任和歧视、政府和制药行业不信任、内在同质性、PrEP 功效不信任和预期同质性。值得注意的是，PrEP 也被积极地描述为具有身心益处，并通过提高 PrEP 意识承担保护社区的责任。PrEP 相关的耻辱依然存在，需要采取干预措施来改变其影响。利用积极的 PrEP 话语来挑战 PrEP 耻辱是一种新兴途径，同时还努力通过减少提供者的偏见来提高提供者常规推广 PrEP 的意愿，与结束艾滋病毒流行的国家战略保持一致。