Academic Journal
Therapeutic equivalence, different stigma: Pills and long-acting injectable antiretroviral treatment imaginaries among gay and bisexual men living with HIV in Colombia.
| Title: | Therapeutic equivalence, different stigma: Pills and long-acting injectable antiretroviral treatment imaginaries among gay and bisexual men living with HIV in Colombia. |
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| Authors: | Brisson J; Dalla Lana School of Public Health, University of Toronto, Canada; Faculté de pharmacie, Université de Montréal, Canada. Electronic address: j.brisson@utoronto.ca., Castro-Arteaga M; Dalla Lana School of Public Health, University of Toronto, Canada., Logie CH; Factor-Inwentash Faculty of Social Work, University of Toronto, Canada., Perez-Brumer A; Dalla Lana School of Public Health, University of Toronto, Canada. |
| Source: | Social science & medicine (1982) [Soc Sci Med] 2026 Jul; Vol. 401, pp. 119357. Date of Electronic Publication: 2026 Apr 30. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Pergamon Country of Publication: England NLM ID: 8303205 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-5347 (Electronic) Linking ISSN: 02779536 NLM ISO Abbreviation: Soc Sci Med Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Oxford ; New York : Pergamon, c1982- |
| MeSH Terms: | HIV Infections*/drug therapy , HIV Infections*/psychology , Homosexuality, Male*/psychology , Bisexuality*/psychology , Sexual and Gender Minorities*/psychology , Anti-HIV Agents*/therapeutic use , Anti-HIV Agents*/administration & dosage , Social Stigma*, Humans ; Male ; Adult ; Colombia ; Qualitative Research ; Middle Aged ; Interviews as Topic ; Injections ; Delayed-Action Preparations |
| Abstract: | Long-acting injectable antiretroviral therapy (LAI-ART) is an emerging HIV treatment whose social implications extend beyond its biomedical effects. To explore how LAI-ART is imagined in contexts where it is not yet available, we conducted 66 semi-structured interviews with gay and bisexual men living with HIV in Colombia. Guided by the concept of the social plasticity of pharmaceuticals - the capacity of medicines to acquire shifting social meanings beyond their pharmacological action - we explored how participants anticipated LAI-ART might reshape HIV-related stigma. First, LAI-ART was imagined as affording freedom from daily pill-taking and the burden of constant HIV management, offering relief from a persistent reminder of living with HIV. Second, oral pill bottles were described as "stigma objects," while injectables were imagined as invisible treatments enabling concealment and reducing social exposure to stigma. Third, participants linked LAI-ART to greater secrecy within social relationships, and framed injectables as symbols of scientific progress that could help dissociate HIV from illness. Finally, some participants emphasized the limits of pharmaceutical solutions, arguing that stigma is rooted not only in treatment practices but in broader contexts of misinformation and moral judgment about HIV. Our findings suggest that while pharmacologically equivalent, oral pills and injectable ART can be socially distinct, with LAI-ART expected to serve as a partial buffer, though not a remedy, for HIV-related stigma. As LAI-ART is not yet available in Colombia, participants' accounts primarily reflect internalized and anticipated stigma; future research is needed to examine its effects on enacted stigma once implementation occurs. (Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors report there are no competing interests to declare. |
| Contributed Indexing: | Keywords: Antiretroviral; Colombia; Gay and bisexual men; HIV; Long-acting; Stigma |
| Substance Nomenclature: | 0 (Delayed-Action Preparations) 0 (Anti-HIV Agents) |
| Entry Date(s): | Date Created: 20260506 Date Completed: 20260716 Latest Revision: 20260716 |
| Update Code: | 20260716 |
| DOI: | 10.1016/j.socscimed.2026.119357 |
| PMID: | 42091001 |
| Database: | MEDLINE |
| ISSN: | 1873-5347 |
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| DOI: | 10.1016/j.socscimed.2026.119357 |