Pre-Exposure Prophylaxis (PrEP) is a novel HIV prevention tool. PrEP stigma is a frequently reported barrier, while social disclosure of PrEP use may be an important facilitator. We explored how PrEP users managed PrEP use disclosure using a symbolic interactionist approach. We interviewed 32 participants from two PrEP demonstration projects (Be-PrEP-ared, Antwerp; AMPrEP, Amsterdam). We validated qualitative findings through Be-PrEP-ared questionnaire data. A minority of participants had received negative reactions on PrEP. The way PrEP use was disclosed was highly dependent on the social situation. In a sexual context among MSM, PrEP use was associated with condomless sex. Friends endorsed PrEP use as a healthy choice, but also related it to carelessness and promiscuity. It was seldom disclosed to colleagues and family, which is mostly related to social norms dictating when it is acceptable to talk about sex. The study findings reveal that PrEP stigma experiences were not frequent in this population, and that PrEP users actively manage disclosure of their PrEP user status. Frequent disclosure and increased use may have helped PrEP becoming normalised in these MSM communities. To increase uptake, peer communication, community activism and framing PrEP as health promotion rather than a risk-reduction intervention may be crucial.

中文翻译：

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PrEP 使用的社会意义——安特卫普和阿姆斯特丹 PrEP 使用披露的混合方法研究

暴露前预防 (PrEP) 是一种新型的 HIV 预防工具。PrEP 的耻辱是一个经常报道的障碍，而 PrEP 使用的社会披露可能是一个重要的促进因素。我们探索了 PrEP 用户如何使用符号交互方法管理 PrEP 使用披露。我们采访了来自两个 PrEP 示范项目（Be-PrEP-ared，安特卫普；AMPrEP，阿姆斯特丹）的 32 名参与者。我们通过 Be-PrEP 调查问卷数据验证了定性结果。少数参与者对 PrEP 有负面反应。PrEP 使用的披露方式在很大程度上取决于社会情况。在 MSM 的性环境中，PrEP 的使用与无安全套性行为有关。朋友们认可使用 PrEP 是一种健康的选择，但也将其与粗心和滥交联系起来。很少向同事和家人透露，这主要与决定何时可以接受谈论性的社会规范有关。研究结果表明，PrEP 耻辱经历在该人群中并不常见，而且 PrEP 用户积极管理其 PrEP 用户状态的披露。频繁披露和增加使用可能有助于 PrEP 在这些 MSM 社区中正常化。为了提高吸收率，同伴交流、社区行动和将 PrEP 定为健康促进而非降低风险干预措施可能至关重要。