Roger-Luc Chayer (Image : AI / Gay Globe)
A piece of information born on social networks that is worrying the gay community
When you let just anyone have access to the internet, anything can be published, and it is up to us, journalists, to separate fact from fiction.
For several months now, an idea has been spreading within the gay community, shocking and worrying people who take PrEP or are considering starting this treatment as part of HIV prevention.
The claim — or rather the rumor — is being circulated that PrEP causes weight gain that is localized only in the abdominal area. This would be the so-called “PrEP belly.” Rumor or recognized medical condition?
Side effects of the first HIV treatments
The first HIV treatments, which appeared in the 1990s with the arrival of triple therapy (notably protease inhibitors and certain nucleoside analogues), made it possible to transform HIV into a chronic disease. But these molecules, such as Indinavir, Stavudine or Zidovudine, had significant side effects, including lipodystrophy.
This phenomenon refers to an abnormal redistribution of fat in the body. In concrete terms, some people lost fat in the face, arms or legs (lipoatrophy), while accumulating it elsewhere, particularly in the abdomen, chest or neck (sometimes referred to as the “buffalo hump”).
The main cause came from the impact of these drugs on cellular metabolism. Some, like stavudine, damaged mitochondria — the “energy power plants” of cells — which disrupted how cells store and use fat. Others, like protease inhibitors, interfered with proteins involved in lipid and insulin regulation, promoting visceral fat accumulation and metabolic disorders.
As a result, the body no longer managed fat normally, creating visible and often stigmatizing changes for patients. At the time, lipodystrophy was frequent enough to become a marker associated with anti-HIV treatments, with a significant psychological impact.
A revolution in modern HIV treatments
While lipodystrophy marked the early days of HIV treatments, it now belongs almost to the past. The reason is a silent revolution in drug design.
Modern treatments were designed specifically to avoid these pitfalls. The molecules used today target the virus in a much more specific way, with greatly reduced cellular toxicity. They no longer interfere, or only minimally, with fat storage mechanisms or hormonal regulation.
Another major change: the most problematic drugs have been gradually abandoned in Western countries, replaced by better-tolerated options. This evolution is based on years of clinical research, but also on increased listening to patients, whose side effects have helped guide therapeutic choices.
Where does the term “PrEP belly” come from and how does it spread?
The term “PrEP belly” does not come from the medical field, but from social networks such as TikTok and X.
Originally, it was mainly a joke or ironic comment about the body — a way of referring to a slight belly and associating it with PrEP use. But as often happens online, this humorous tone gradually became blurred. Reused out of context, the term began to be interpreted literally, until it became, for some, a supposed medical reality.
Its spread follows a well-known mechanism: virality, repetition and echo chamber effects. Content accumulates views, is shared without verification, then amplified by algorithms that favor emotional or controversial content. At the same time, the lack of nuance — particularly regarding the real and documented effects of PrEP — contributes to sustaining confusion.
PrEP belly: a rumor without scientific basis
Based on the facts, “PrEP belly” is exactly what it is: an online-born rumor with no scientific foundation. No medical data establishes any link between PrEP and weight gain localized in the abdominal area. This shift from a viral joke to a widely shared belief is a reminder of how easily information can be distorted when it circulates without filtering.
Testimony: Guy believed in “PrEP belly”
Guy remembers very clearly the moment everything changed. He had already been on PrEP for several years without any issues, convinced he had found a simple and reassuring routine to protect himself from HIV. “I had been taking it for at least five years, and I never had any problem,” he says.
Then one evening, while browsing social media, he came across a series of posts mentioning “PrEP belly.” Testimonials, comparison photos, alarming comments. Doubt quickly set in. “I started looking at myself differently in the mirror. I began analyzing my stomach, wondering if I was really changing.”
Within a few days, concern took over. Guy ended up stopping PrEP, despite years without incident. “I was afraid of something I didn’t even really understand. It was like the information online had taken over my own experience.”
It was only during a medical appointment that things became clear. His doctor explained that there is no scientific evidence of such a side effect, and that “PrEP belly” is not recognized in medicine. “He looked at me and simply said: it doesn’t exist as a side effect of PrEP.”
Relieved, but also somewhat unsettled by his reaction, Guy resumed his treatment. In hindsight, he describes it as an eye-opening episode. “I realized how much a misunderstood piece of information can create fear, even when you are already under medical care.”
A public health and media responsibility issue
In a context where PrEP remains an essential tool in HIV prevention, spreading this kind of myth is not harmless. It fuels unjustified fears and may discourage access to a treatment that is nevertheless recognized for its effectiveness and safety.
Restoring the facts also means reaffirming a responsibility: distinguishing digital noise from medical reality, especially when public health is at stake.
And this is certainly the role of gay media to do so!
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