A Longitudinal, Qualitative Exploration of Perceived HIV Risk, Healthcare Experiences, and Social Support as Facilitators and Barriers to PrEP Adoption Among Black Women

Nydegger, Liesl A.; Dickson‐Gómez, Julia; Ko, Thant Ko

doi:10.1007/s10461-020-03015-9

Cited by 58 publications

(39 citation statements)

References 35 publications

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“…The historical context of unethical medical practices (e.g., Tuskegee Syphilis Study, Mississippi Appendectomies) and discriminatory experiences within the healthcare system has significantly contributed to medical mistrust in the Black community [ 36 , 37 ]. Medical mistrust can shape interest and willingness to use PrEP among women [ 15 , 38 ], such that Black women with strong concerns regarding the trustworthiness of the PrEP medication and healthcare system may be less likely to discuss or use PrEP [ 20 , 39 ]. High medical mistrust is also related to low PrEP adherence in other diverse populations [ 40 , 41 ], but conceptually , this relationship may also exist among Black cisgender women.…”

Section: Introductionmentioning

confidence: 99%

“PrEP’s just to secure you like insurance”: a qualitative study on HIV pre-exposure prophylaxis (PrEP) adherence and retention among black cisgender women in Mississippi

Willie

Monger²,

Nunn

et al. 2021

BMC Infect Dis

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Background Pre-exposure prophylaxis (PrEP) has the potential to reduce transmission of HIV among Black cisgender women in the Southern United States (U.S.); however, national data suggests that PrEP initiation is lowest in the South and among Black women compared to other U.S. regions and white women. This study applied intersectionality and PrEP multilevel resilience frameworks to assess how socio-structural and clinical contexts shaped PrEP persistence among Black cisgender women in Mississippi. Methods Semi-structured interviews were conducted with eight Black cisgender women in Jackson, Mississippi. This sample was purposively recruited to include PrEP-initiated Black cisgender women. Results Six themes identified that shaped PrEP care among Black cisgender women: (1) internal assets, (2) sole responsibility to HIV prevention, (3) added protection in HIV serodifferent relationships, (4) financial issues, (5) trust and distrust in the medical system, and (6) side effects. Black cisgender women reported that PrEP persistence increased control over their sexual health, reduced anxiety about HIV, and promoted self-care. Black cisgender women also indicated that medication assistance programs increased PrEP affordability resulting in continued persistence. Conclusions In addition to preventing HIV, PrEP may yield secondary positive impacts on the health and relationships of Black cisgender women. However, very few Black cisgender women in the South are using PrEP given intersectional barriers and thus necessitates adaptive strategies to support PrEP initiation and persistence. Efforts aimed at increasing the coverage of PrEP among Black cisgender women should consider implementation strategies responsive to lived realities of Black women.

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Section: Introductionmentioning

confidence: 99%

“PrEP’s just to secure you like insurance”: a qualitative study on HIV pre-exposure prophylaxis (PrEP) adherence and retention among black cisgender women in Mississippi

Willie

Monger²,

Nunn

et al. 2021

BMC Infect Dis

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“…There is prior evidence that loneliness has increased more among adolescents relative to other age groups during the COVID-19 pandemic [ 55 ], and it appears that increased loneliness may be associated with greater medical mistrust. Prior research has shown that those who have others in their support network who engage in a medical treatment or health behavior (e.g., uptake of pre-exposure prophylaxis [PrEP]) tend to have less hesitancy in engaging in the health-related behavior themselves [ 56 ]. As such, if youth of color feel isolated from their social network during the COIVD-19 pandemic, they are presumably less likely to share information and support related to medical care access and decision making.…”

Section: Discussionmentioning

confidence: 99%

Predictors of medical mistrust among urban youth of color during the COVID-19 pandemic

Ash

Berkley‐Patton

Christensen

et al. 2021

Translational Behavioral Medicine

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The COVID-19 pandemic has disproportionately impacted communities of color and highlighted longstanding racial health inequities. Communities of color also report higher rates of medical mistrust driven by histories of medical mistreatment and continued experiences of discrimination and systemic racism. Medical mistrust may exacerbate COVID-19 disparities. This study utilizes the Behavior Model for Vulnerable Populations to investigate predictors of medical mistrust during the COVID-19 pandemic among urban youth of color. Minority youth (N = 105) were recruited from community organizations in Kansas City, Missouri to complete an online survey between May and June 2020. Multiple linear regressions were performed to estimate the effect of personal characteristics, family and community resources, and COVID-19 need-based factors on medical mistrust. Results indicated that loneliness, financial insecurity (e.g., job loss, loss of income) due to the COVID-19 pandemic, and eligibility for free or reduced lunch predicted medical mistrust. Insurance status, neighborhood median household income, social support, and perceived COVID-19 risk were not significantly associated with medical mistrust. Future research and policies are necessary to address systemic factors that perpetuate medical mistrust among youth of color.

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“…The historical context of unethical medical research and practices against Black communities (e.g., the Tuskegee syphilis study; coerced sterilization) has created a culture in which health care practices reinforce discrimination (Williams & Mohammed, 2013), resulting in a deep level of medical mistrust (LaVeist, Nickerson, & Bowie, 2000). Medical mistrust is related to fewer positive PrEP attitudes and intentions among Black women (Nydegger, Dickson-Gomez, & Ko, 2021;Tekeste et al, 2018). Using trauma-informed approaches with an intersectional lens not only ensures that staff are knowledgeable about historical contexts, but actively engages in patientprovider discussions that recognize how this history might be an important driver of PrEP deliberation or rumination among Black women.…”

Section: Cultural Historical and Gender Issues Or Intersectionalitymentioning

confidence: 99%

No Longer the Exception, but the Standard: Integrating Trauma-Informed Policy and Pre-exposure Prophylaxis Implementation for Women

Willie

Alexander

Kershaw³

et al. 2021

Women's Health Issues

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Almost four decades into the national HIV/AIDS epidemic, women remain significantly impacted. Heterosexually active women are a key population targeted in national HIV prevention efforts (Short, Sutton, Luo, & Frazier, 2019). In 2018, women represented 19% of all new HIV diagnoses in the United States. Among heterosexual women, unprotected condomless vaginal and/or anal sex with a male partner is the primary mode of HIV transmission and accounts for 85% of HIV diagnoses among women (Centers for Disease Control and Prevention, 2017a).

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A Longitudinal, Qualitative Exploration of Perceived HIV Risk, Healthcare Experiences, and Social Support as Facilitators and Barriers to PrEP Adoption Among Black Women

Cited by 58 publications

References 35 publications

“PrEP’s just to secure you like insurance”: a qualitative study on HIV pre-exposure prophylaxis (PrEP) adherence and retention among black cisgender women in Mississippi

“PrEP’s just to secure you like insurance”: a qualitative study on HIV pre-exposure prophylaxis (PrEP) adherence and retention among black cisgender women in Mississippi

Predictors of medical mistrust among urban youth of color during the COVID-19 pandemic

No Longer the Exception, but the Standard: Integrating Trauma-Informed Policy and Pre-exposure Prophylaxis Implementation for Women

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