Pre-exposure Prophylaxis (PrEP) Initiation Among Black and Latina Cisgender Women Receiving HIV Prevention Care Coordination Services in New York City

Background HIV pre-exposure prophylaxis (PrEP) uptake in women remains low. We developed a laboratory result-driven protocol to link women with a positive bacterial sexually transmitted infection (STI) to HIV PrEP at an urban, safety-net hospital. Methods Electronic health records of women with positive chlamydia, gonorrhea, and/or syphilis tests were reviewed and those eligible for PrEP were referred for direct or primary care provider-driven outreach. We assessed the proportion of women with STI who received PrEP offers, acceptance, and prescriptions before (July 1, 2018 - December 31, 2018) and after (January 1, 2019 – June 30, 2020) implementation to evaluate changes in the delivery of key elements of the PrEP care cascade (i.e., PrEP offers, acceptance, and prescribing) for women with STI after protocol implementation Results The proportion of women who received PrEP offers increased from 7.6% to 17.6% (p < 0.001). After multivariable adjustment, only the post-intervention period was associated with PrEP offer (OR 2.49, 95% CI 1.68-3.68). In subgroup analyses, PrEP offers increased significantly among non-Hispanic Black (OR 2.75, 95% CI 1.65-4.58) and Hispanic (OR 5.34, 95% CI 1.77-16.11) women but not among non-Hispanic white women (OR 1.49, 95% CI 0.54-4.05). Significant changes in PrEP acceptance and prescriptions were not observed in the sample overall. Conclusion A laboratory result-driven protocol was associated with a significant increase in PrEP offers to Black and Hispanic women with STI. Results provide concrete suggestions for health systems seeking to increase PrEP access and equity among women.

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Confidence in Ability to Communicate With Sexual Partners About PrEP Among Black Cisgender Women

Irie,

Mahone,

Nakka

et al. 2023

AIDS Education and Prevention

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This study explored the factors associated with Black women's confidence in their ability to engage male sexual partners in discussions about PrEP. Communication about PrEP with male partners is an important, yet minimally explored, outcome in PrEP research among Black women in heterosexual partnerships. Among 315 respondents, results show significant differences in anticipated stigma and interest in PrEP between a binary outcome variable being confident and not-confident discussing PrEP with sexual partners. Further, factors such as employment, worrying about HIV infection, interest in taking oral PrEP, subjective norms, injunctive norms, and descriptive norms were associated with Black women's higher odds of confidence in their ability to engage sexual partners about PrEP. Conversely, PrEP disapproval and stigma resulted in lower odds of Black women's confidence in their ability to engage sexual partners about PrEP. Results indicate the need for continued investigation of confidence and, relatedly, communication about PrEP among heterosexual couples and communitylevel interventions normalizing PrEP discussions and uptake.

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Pre-exposure Prophylaxis (PrEP) Initiation Among Black and Latina Cisgender Women Receiving HIV Prevention Care Coordination Services in New York City

Cited by 6 publications

References 36 publications

Understanding Attitudes of Postpartum Cisgender Women Toward Integration of HIV Prevention Services into Routine Prenatal and Postpartum Sexual Health Discussions

Understanding Attitudes of Postpartum Cisgender Women Toward Integration of HIV Prevention Services into Routine Prenatal and Postpartum Sexual Health Discussions

Addressing Unmet PrEP Needs in Women: Impact of a Laboratory-Driven Protocol at an Urban, Essential Hospital

Confidence in Ability to Communicate With Sexual Partners About PrEP Among Black Cisgender Women

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