{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T22:25:51Z","timestamp":1787005551854,"version":"build-2736575974"},"reference-count":28,"publisher":"CSIRO Publishing","issue":"1","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":2090,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,2,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>HIV disproportionately affects cisgender men and transgender people who have sex with men (MSM\/TG) and use methamphetamine. Pre-exposure prophylaxis (PrEP) uptake has been slow in this group. It is important to understand perceptions about PrEP and barriers to its use among MSM\/TG who use methamphetamine to reduce new HIV infections. Methods: We conducted four focus groups with peer educators of a harm reduction program. We assessed their perspectives of PrEP and barriers across the PrEP continuum among MSM\/TG who use methamphetamine. Results: Notably, stigma related to the multiple marginalised identities of MSM\/TG who use methamphetamine (e.g. MSM\/TG-related stigma, methamphetamine-related stigma) was a barrier at each step. We developed a framework that combined the PrEP continuum and a stigma-based treatment cascade to explore these themes and describe the effects of stigma on PrEP engagement. Methamphetamine-related barriers were also identified. Conclusions: The findings of this study emphasise the importance of incorporating stigma reduction into PrEP delivery for MSM\/TG who use methamphetamine.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/sh19083","type":"journal-article","created":{"date-parts":[[2019,12,8]],"date-time":"2019-12-08T17:51:58Z","timestamp":1575827518000},"page":"29-37","source":"Crossref","is-referenced-by-count":18,"title":["\u2018I make sure my doctor doesn\u2019t know that I use meth\u2019: perceived barriers to pre-exposure prophylaxis (PrEP) uptake among community peer educators in Seattle (WA, USA)"],"prefix":"10.1071","volume":"17","author":[{"given":"Vanessa M.","family":"McMahan","sequence":"first","affiliation":[{"name":"ADepartment of Medicine, University of Washington, 325 9th Avenue, Seattle, WA, 98104, USA."},{"name":"FCorresponding author. Email: vmcmahan@uw.edu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren R.","family":"Violette","sequence":"additional","affiliation":[{"name":"ADepartment of Medicine, University of Washington, 325 9th Avenue, Seattle, WA, 98104, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele P.","family":"Andrasik","sequence":"additional","affiliation":[{"name":"BDepartment of Global Health, University of Washington, 1510 San Juan Road, Seattle, WA, 98195 USA."},{"name":"CFred Hutch, HIV Vaccine Trials Network, 1100 Fairview Avenue N, Seattle, WA, 98109, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleks","family":"Martin","sequence":"additional","affiliation":[{"name":"DProject NEON, Seattle Counseling Service, 1216 Pine Street, Suite 300, Seattle, WA, 98101, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay","family":"Garske","sequence":"additional","affiliation":[{"name":"DProject NEON, Seattle Counseling Service, 1216 Pine Street, Suite 300, Seattle, WA, 98101, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne D.","family":"Stekler","sequence":"additional","affiliation":[{"name":"ADepartment of Medicine, University of Washington, 325 9th Avenue, Seattle, WA, 98104, USA."},{"name":"BDepartment of Global Health, University of Washington, 1510 San Juan Road, Seattle, WA, 98195 USA."},{"name":"EDepartment of Epidemiology, University of Washington, 1959 NE Pacific Street Seattle, WA, 98195 USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"67","published-online":{"date-parts":[[2019,12,9]]},"reference":[{"key":"2025102617165658200_R1","doi-asserted-by":"publisher","first-page":"113","DOI":"10.2105\/AJPH.88.1.113","article-title":"Histories of substance use and risk behavior: precursors to HIV seroconversion in homosexual men.","volume":"88","author":"Chesney","year":"1998","journal-title":"Am J Public 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Addressing stigma: a blueprint for improving HIV\/STD prevention and care outcomes for Black & Latino gay men. 2014. 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