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Why Aren't More Straight People on PrEP?

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Heterosexual people accounted for 22 percent of new infections in 2020.

Pre-exposure prophylaxis, or PrEP, is the number one form of HIV prevention, but marketing efforts for the medication are historically targeted towards men who have sex with men.

While this community is largely at a higher risk for HIV, this has left an open gap in messaging for the heterosexual community.

In 2020, the Centers for Disease Control and Prevention reported that heterosexual people made up 22 percent of the 30,635 new HIV diagnoses that year. The United Kingdom also reported that new HIV cases were higher in heterosexual people than gays and bisexuals for the first time in a decade.

Perceptions that HIV is a “gay disease” play a part in the struggle to broaden the message for HIV care.

“I believe there is stigma attached to PrEP that unfortunately keeps straight/cisgender people from accessing it at the rates this population should,” Dr. Monica Gandhi, MPH, told Healthline. “The CDC estimates that 1.2 million people require pre-exposure prophylaxis in the US, but fewer than 25% are taking it.”

Gandhi noted the troubling CDC statistics “means we have to redouble our efforts to reach heterosexual, cisgender women and men with our PrEP messaging. In fact, two of the biggest PrEP trials that led to the approval of PrEP were in heterosexual couples.”

Younger generations are more likely to remain open-minded to this medication as opposed to older generations. In the battle against HIV stigma, education remains a primary issue. Clinicians especially need more training and knowledge on this topic.

Advancements like tele-PrEP services and the new federal budget to cover PrEP in the underinsured or uninsured help with making the medication more accessible.

With nearly 1 in 7 people living with HIV unaware of their status, getting tested and considering PrEP can help you and those around you stay safe and protected.

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Andrew J. Stillman

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