Year of Publication
2024
College
Public Health
Date Available
10-27-2024
Degree Name
Master of Public Health (M.P.H.)
Committee Member
Dr. Florence Fulk
Advisor
Dr. Rachel Vickers-Smith
Committee Member
Dr. Kathleen Winter
Co-Director of Graduate Studies
Dr. Hilary Surratt
Abstract
Background: Injection drug use has increased HIV burden in low-prevalence communities, specifically within rural Kentucky. Pre-exposure prophylaxis (PrEP) has been successful in terms of HIV prevention, yet uptake remains low among people who inject drugs (PWID). PWID living in rural areas face unique challenges to receiving PrEP care, including significant barriers of substance use- and HIV-related stigma. Recent studies have only started to explore the overlapping effects of these two stigmas. Considering the barriers each stigma independently poses to PrEP care, it is important to investigate their role in tandem for any compounding effects. This paper is a secondary analysis on the effects of intersectional stigma on written PrEP prescription.
Methods: This study analyzed baseline survey and clinical visit data collected by the RISE HIV Prevention Trial – Aim 3 Assessment from 2022 to 2024. Eighty participants were enrolled for pilot trial among two county SSP locations in rural southeastern Kentucky. Our analytic sample excluded participants who reported never experiencing either stigma, substance- or HIV-related. Exact logistic regression was used to analyze the relationship between intersectional stigma status (experiences of HIV- and substance-related stigma) and written PrEP prescription.
Results: Among our analytic sample, 55.7% of participants had intersectional experiences of stigma. Those who reported intersectional experiences of stigma had 1.28 times the odds of receiving written PrEP prescription compared to those with individual experiences of stigma.
Conclusion: The measures of association indicate that experiences of individual and intersectional stigma yield differing probabilities of receiving PrEP prescription. Further research will be needed to explore conflicting findings among this theory.
Recommended Citation
Burton, Abby, "The Effects of Stigma within the PrEP Care Cascade Among People Who Inject Drugs in Rural Kentucky" (2024). Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.). 434.
https://uknowledge.uky.edu/cph_etds/434
