A new study from the University of California San Francisco has identified a troubling connection between social stigma and medication adherence in one of the world’s most vulnerable populations. Research published in BMJ Global Health tracked 262 sex workers in Lusaka, Zambia, revealing that those experiencing chronic discrimination were 65% more likely to discontinue pre-exposure prophylaxis (PrEP) within three months. This finding is particularly concerning given that sex workers face a 21-fold higher risk of HIV acquisition compared to the general population. The prospective cohort study, conducted between July and October 2023, emphasizes how discrimination—primarily tied to occupational stigma—undermines access to life-saving prevention tools. Beyond chronic discrimination affecting 28.2% of participants, the research identified additional barriers including PrEP-specific stigma (22.5%) and HIV-related stigma (20.2%). These overlapping forms of discrimination create compounding barriers to health equity and prevention success.
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