AIDS and Behavior

, Volume 20, Issue 7, pp 1499–1513 | Cite as

Framing HIV Pre-Exposure Prophylaxis (PrEP) for the General Public: How Inclusive Messaging May Prevent Prejudice from Diminishing Public Support

  • Sarah K. Calabrese
  • Kristen Underhill
  • Valerie A. Earnshaw
  • Nathan B. Hansen
  • Trace S. Kershaw
  • Manya Magnus
  • Douglas S. Krakower
  • Kenneth H. Mayer
  • Joseph R. Betancourt
  • John F. Dovidio
Original Paper


Strategic framing of public messages about HIV pre-exposure prophylaxis (PrEP) may influence public support for policies and programs affecting access. This survey study examined how public attitudes toward PrEP differed based on the social group PrEP was described as benefiting (“beneficiary”) and the moderating effect of prejudice. Members of the general public (n = 154) recruited online were randomly assigned to three beneficiary conditions: general population, gay men, or Black gay men. All participants received identical PrEP background information before completing measures of PrEP attitudes (specifying beneficiary), racism, and heterosexism. Despite anticipating greater PrEP adherence among gay men and Black gay men and perceiving PrEP as especially beneficial to the latter, participants expressed lower support for policies/programs making PrEP affordable for these groups vs. the general population. This disparity in support was stronger among participants reporting greater prejudice. Inclusive framing of PrEP in public discourse may prevent prejudice from undermining implementation efforts.


HIV Pre-exposure prophylaxis (PrEP) Framing Public opinion Prejudice Black/African American Men who have sex with men (MSM) 



This research was supported by Award Numbers K01-MH103080 and P30-MH062294 from the National Institute of Mental Health (NIMH) and the Yale University Fund for Lesbian and Gay Studies Award. Kristen Underhill and Douglas S. Krakower were supported by NIMH Award Numbers K01-MH093273 and K23-MH098795, respectively. Valerie A. Earnshaw was supported by the Agency for Healthcare Research and Quality (AHRQ) Award Number K12-HS022986. Mentorship was received from the Social and Behavioral Sciences Research Network (SBSRN) of the National Institutes of Health Centers for AIDS Research (2013 SBSRN National Scientific Meeting Mentoring Day) and P30-AI060354. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the NIMH, the SBSRN, the National Institutes of Health, the AHRQ, or Yale Lesbian and Gay Studies. The authors wish to thank Valen Grandelski for programming the survey, Suzanne Horowitz for her technical assistance on the survey, and Adam Eldahan for his support with reference management software and proofreading. The authors are also grateful to the individuals who generously contributed their time and effort by participating in this study.

Supplementary material

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Supplementary material 1 (DOCX 590 kb)


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Sarah K. Calabrese
    • 1
    • 2
  • Kristen Underhill
    • 2
    • 3
  • Valerie A. Earnshaw
    • 2
    • 4
  • Nathan B. Hansen
    • 2
    • 5
  • Trace S. Kershaw
    • 1
    • 2
  • Manya Magnus
    • 6
  • Douglas S. Krakower
    • 7
    • 8
  • Kenneth H. Mayer
    • 7
    • 8
  • Joseph R. Betancourt
    • 9
  • John F. Dovidio
    • 2
    • 10
  1. 1.Department of Chronic Disease EpidemiologyYale School of Public Health, Yale UniversityNew HavenUSA
  2. 2.Center for Interdisciplinary Research on AIDSYale UniversityNew HavenUSA
  3. 3.Yale Law School, Yale UniversityNew HavenUSA
  4. 4.Boston Children’s Hospital, Harvard Medical SchoolBostonUSA
  5. 5.Department of Health Promotion and Behavior, College of Public HealthUniversity of GeorgiaAthensUSA
  6. 6.Department of Epidemiology and BiostatisticsMilken Institute School of Public Health, George Washington UniversityWashingtonUSA
  7. 7.Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonUSA
  8. 8.The Fenway InstituteFenway HealthBostonUSA
  9. 9.Disparities Solutions CenterMassachusetts General Hospital, Harvard Medical SchoolBostonUSA
  10. 10.Department of PsychologyYale UniversityNew HavenUSA

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