Perspectives of US women participating in a candidate PrEP study: adherence, acceptability and future use intentions

Abstract

Introduction Limited data exist on acceptability of candidate pre‐exposure prophylaxis (PrEP) regimens among US women. We evaluated PrEP experiences, attitudes and future use intentions among sexually active women who completed the US‐based HIV Prevention Trials Network 069/AIDS Clinical Trials Group 5305 study. Methods Women participated in the study between March 2013 and November 2015. We analysed computer‐assisted self‐interview (CASI) surveys among 130 women and conducted in‐depth interviews among a subset of 26 women from three sites. Interviews were conducted in mid/late‐2015. Results Most women (57%) reported very good/excellent PrEP adherence on CASI, although 21% acknowledged over‐reporting adherence at least some of the time. Commitment to preventing HIV infection, a sense of ownership of the study, and keeping pills stored in a visible location facilitated adherence. Adherence barriers included “simply forgetting” and being away from home. Most women interviewed did not intend to use PrEP in the future because of lack of perceived need due to their own (as opposed to their partners’) low‐risk behaviour and concerns about affordability – but not because of side effects or other characteristics of the regimens. Conclusions Improving HIV prevention options for US women will require access to affordable PrEP as well as expanding women's understanding of relationship‐ and community‐level factors that increase their risk of acquiring HIV.

“Yes, I’m interested in taking PrEP!”: PrEP interest among women respondents to the European community-based survey “Flash! PrEP in Europe”

“…In this analysis, women with rather high/high HIV risk perception also reported higher interest in PrEP, supporting previous findings among women [ 32 , 38 , 39 ] and other key populations, that perception of HIV risk is an important factor of PrEP interest [ 40 – 43 ]. Additionally, high risk perception may play an important role in PrEP adherence [ 17 , 39 , 44 ], a key lesson from the PrEP implementation process in the US [ 40 ].…”

Achievements and gaps to provide pre-exposure prophylaxis (PrEP) for women across the European Region – Results from a European survey study

“…23 Having a history of partner violence, being recently diagnosed with a STI, and living in a high prevalence area, have also been cited in the literature as characteristics associated with PrEP eligibility among women. 22 , 24 Perceptions of HIV risk have been reported to be highly gendered and one challenge may be that many women do not consider themselves at risk of HIV acquisition 25 , 26 , particularly if they consider themselves to be in a monogamous relationship. A holistic discourse about HIV risk and risk perception that includes partner, structural and community influences may thus be particularly important for women’s uptake of PrEP.…”

“…A holistic discourse about HIV risk and risk perception that includes partner, structural and community influences may thus be particularly important for women’s uptake of PrEP. 25 Access to PrEP should be based on the actual risk of HIV acquisition, not on the risk group per se , so that individuals, irrespective of gender, who, in the opinion of their physician, have a high risk of HIV acquisition should be eligible for PrEP.…”

“…Results from several studies suggest that women, when provided with information on the effectiveness of PrEP, are generally keen to take it. 22 , 25 , 27 , 28 However, one challenge to PrEP provision for women is that the awareness of PrEP is generally low among women. 29 In a recent study among 109 African-American women attending a family planning clinic, 80% reported that they were unaware of PrEP being available and 70% reported that they would probably or definitely like to use it.…”

Efficacy, Adherence and Side Effects of PrEP for HIV-1 Prevention

“…For PrEP to be effective, it has to be administered every day. Several factors may interfere the routine, including being away from home, busy work schedule (Karim et al, 2018), change of life style, lack of scheduled time, emotional instability, difficulty in purchase of drug, and so on (Hunt et al, 2019;Amico et al, 2019).…”