Despite being at the cornerstone of current initiatives to curtail the spread of HIV, Pre-Exposure Prophylaxis (PrEP) medication has been slow to proliferate among many "at risk" populations. This is true for men who have sex with other men (MSM), who account for the largest number of new HIV diagnoses in the United States. To try to understand why MSM are not adopting PrEP in greater numbers, the present authors have created a 22-item PrEP Stigma Scale. This paper reports findings for that scale.
Methods: Purposive sampling was used to derive a sample of 273 diverse MSM. Men completed a brief questionnaire inquiring about their awareness of PrEP, willingness to avail themselves of various sources of information about PrEP, perceptions about PrEP-related stigma, and perceptions about obstacles to PrEP use. Cronbach's alpha reliability coefficients were computed for the PrEP Stigma Scale, for the full sample and for key subgroups. Factor analysis was performed to determine whether or not subscales exist.
Results: The PrEP Stigma Scale was found to be highly reliable, both in its full version (alpha=0.96) and in its shortened version (alpha=0.95). Reliability estimates were strong for all subgroups based on age, race, sexual orientation, educational attainment, relationship status, and HIV serostatus. Two subscales were identified, each with excellent reliability (alpha=0.95 and 0.94), again for the sample as a whole and for all key subgroups.
Conclusions: The PrEP Stigma Scale shows great promise for aiding our understanding of why more MSM are not adopting PrEP. It was found to be reliable for all key subgroups under examination, and that is true both for the 22-item and the 11-item version of the scale.
Keywords: Pre-Exposure Prophylaxis (PrEP); gay men; men who have sex with men (MSM); scale reliability; stigma.