{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T14:53:36Z","timestamp":1775487216579,"version":"3.50.1"},"reference-count":66,"publisher":"BMJ","issue":"8","funder":[{"DOI":"10.13039\/100011326","name":"London School of Economics and Political Science","doi-asserted-by":"publisher","award":["Titmuss Meinhardt Research Grant, Department of So"],"award-info":[{"award-number":["Titmuss Meinhardt Research Grant, Department of So"]}],"id":[{"id":"10.13039\/100011326","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,8,6]]},"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study examines how the perceived role of poor lifestyle and irresponsible behaviour in contracting HIV, human papilloma virus (HPV) and diabetes affects public support for government-provisioned prevention efforts in Britain. It assesses whether public attitudes on healthcare spending are broadly sensitive to \u2018lifestyle stigmas\u2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an online survey of 738 respondents in Britain and embedded three separate survey experiments to measure support for government-provisioned interventions for HIV, HPV and type 2 diabetes. In each experiment, we manipulated language used to describe the extent to which the diseases are caused by lifestyle choices. Most respondents participated in all three experiments, but assignment was randomised within each condition. Analysis compared support among respondents exposed to \u2018lifestyle\u2019 treatment (information emphasising the disease\u2019s lifestyle causes) versus control treatment. We estimated three separate t-tests in which support for government provision of interventions is the dependent variable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Support for government-provisioned prevention was high for all three diseases. There was no statistical difference between treatment and control conditions for HIV (treatment mean=3.73, control mean=3.86, p=0.38). But in both HPV (treatment mean=3.96, control mean=4.43, p&lt;0.01) and type 2 diabetes (treatment mean=3.53, control mean=4.03, p&lt;0.01) experiments, support for government-provisioned interventions was significantly lower under lifestyle treatment conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Public opinion on healthcare expenditures in Britain is unexpected and uneven. Consistent participant support for pre-exposure prophylaxis (PrEP) shows public attitudes are not always sensitive to lifestyle stigmas\u2014but for other diseases, perceived relationships between individual behaviour and poor health can still shape public opinion about health expenditures. Policymakers and practitioners should remain attentive to how health problems are framed and discussed to ensure broad public support, and take advantage of policy windows like with PrEP as they may close.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-029747","type":"journal-article","created":{"date-parts":[[2019,8,23]],"date-time":"2019-08-23T04:55:14Z","timestamp":1566536114000},"page":"e029747","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Effect of \u2018lifestyle stigma\u2019 on public support for NHS-provisioned pre-exposure prophylaxis (PrEP) and preventative interventions for HPV and type 2 diabetes: a nationwide UK survey"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2970-8638","authenticated-orcid":false,"given":"Timothy","family":"Hildebrandt","sequence":"first","affiliation":[{"name":"Department of Social Policy, London School of Economics and Political Science, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leticia","family":"Bode","sequence":"additional","affiliation":[{"name":"Communication, Culture & Technology, Georgetown University, Washington, DC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica S C","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Social Policy, London School of Economics and Political Science, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,8,22]]},"reference":[{"key":"2025121514531952000_9.8.e029747.1","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/S0140-6736(15)00056-2","article-title":"Pre-Exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial","volume":"387","author":"McCormack","year":"2016","journal-title":"The Lancet"},{"key":"2025121514531952000_9.8.e029747.2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-156-8-201204170-00004"},{"key":"2025121514531952000_9.8.e029747.3","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/S1473-3099(17)30540-6","article-title":"Cost-Effectiveness of pre-exposure prophylaxis for HIV prevention in men who have sex with men in the UK: a modelling study and health economic evaluation","volume":"18","author":"Cambiano","year":"2018","journal-title":"Lancet Infect Dis"},{"key":"2025121514531952000_9.8.e029747.4","unstructured":"Ridley L . Daily Mail calls HIV prevention drug PrEP a \u2018lifestyle drug.\u2019. Available: http:\/\/www.huffingtonpost.co.uk\/entry\/prep-hiv-prevention-drug-daily-mail-nhs_uk_57a19640e4b07cb01dd0c6fe [Accessed 20 Oct 2016]."},{"key":"2025121514531952000_9.8.e029747.5","unstructured":"National centre for social research . British social attitudes, 34. 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