The pre-exposure prophylaxis (PrEP) consciousness of black college women and the perceived hesitancy of public health institutions to curtail HIV in black women

Abstract

Background: Consistent use of Pre-Exposure Prophylaxis (PrEP), a biomedical intervention for HIV seronegative persons, has been shown to significantly decrease HIV acquisition. Black women are a viable population segment to consider for PrEP use as their HIV incidence is overwhelmingly higher than all other women groups. Methods: We developed and piloted a cultural-and age-appropriate PrEP education intervention to determine Black college women's: 1) perceptions of and receptivity to PrEP use; and 2) preferences for PrEP information delivery. Results: We recruited N = 43 Black college women. Most of our sample were sophomore and Juniors of whom identified as heterosexual (83%) and single (67%). Over 50% of young women had never been HIV tested and only 28% had been tested in the last 6 months; however, 100% of the women believed their HIV status was negative. Prior to participating in the study, most Black college women (67%) had not heard about PrEP and were unsure or apprehensive (72%) to initiate PrEP. The Black college women indicated that our educational intervention was extremely helpful (67%) for understanding and learning about PrEP. Post participating in our PrEP education module, regardless of delivery modality, participants reported being likely (62.55-70%) to initiate PrEP in the future. Conclusions: Results indicate that Black college women would strongly consider PrEP when provided with basic knowledge, regardless of delivery modality. Participants also showed greater appreciation for in-person delivery and found it to be significantly more helpful and of greater quality for learning about PrEP; comprehension or perceived usefulness of PrEP-related content was relatively the same between groups. PrEP content delivery-via in-person or online methodsis contingent on learning style and presentation. Trial registration: This study has been registered under the ISRCTN Registry as of July 6, 2020. The trial registration number is ISRCTN14792715. This study was retrospectively registered.

Electronic Dissemination of a Web-Based Video Promotes PrEP Contemplation and Conversation Among US Women Engaged in Care at Planned Parenthood

“…Hearing directly from peers about their experiences taking PrEP could help to allay specific medication-related concerns [ 19 ]. In addition, social marketing that reduces HIV- and PrEP-related stigma and communicates the relevance of PrEP to women could help to overcome social challenges and misperceptions on a broader scale [ 9 , 21 , 23 ]. Beyond addressing perceived barriers, PrEP interventions should underscore the prospective benefits of PrEP, which may be similarly or more influential to individuals’ assessment of their own PrEP candidacy [ 28 ].…”

“…In addition, the video was intended to be suitable for patients with minimal PrEP knowledge, rendering it appropriate for many of the patients who elected to watch it in our study—68% of women in the Web Video Condition analytic sample had never previously heard of PrEP. However, patients who are already familiar with PrEP and contemplating usage or (dis)continuation may benefit from a video incorporating other information, such as details about local HIV epidemiology, guidance on sexual health communication, or instructions for accessing PrEP financial assistance [ 9 , 14 ]. Although the majority of participants in the Web Video Condition indicated that the video held their attention, it is possible that expanding the web-based intervention to incorporate not only video viewing but also interactive elements such as games or personalized role plays could promote more active engagement [ 9 , 14 ].…”

“…However, patients who are already familiar with PrEP and contemplating usage or (dis)continuation may benefit from a video incorporating other information, such as details about local HIV epidemiology, guidance on sexual health communication, or instructions for accessing PrEP financial assistance [ 9 , 14 ]. Although the majority of participants in the Web Video Condition indicated that the video held their attention, it is possible that expanding the web-based intervention to incorporate not only video viewing but also interactive elements such as games or personalized role plays could promote more active engagement [ 9 , 14 ]. Future work aimed at tailoring this video or other web-based PrEP educational interventions to optimize impact with a given population may benefit from preliminary assessment of the population’s pre-existing PrEP knowledge and preferences as well as systematic comparison of multiple versions of the intervention in which key elements are varied.…”

“…In studies conducted with women, including studies with Black and Latinx women specifically, electronically-delivered HIV prevention interventions have been highly acceptable and similar or superior in efficacy than interventions delivered in person [ 8 – 14 ]. To date, few studies have evaluated electronically-delivered interventions that focus particularly on PrEP education among women [ 8 , 9 ]. One study evaluated a brief web-based educational video about PrEP among a community-based sample of 116 Black women and found the video to be highly acceptable [ 8 ].…”

Changing the PrEP Narrative: A Call to Action to Increase PrEP Uptake among Women

“…The highest rates of poverty in the US are found among women, due to gender wage and wealth gaps, segregation into low-paying jobs, and inadequate or inaccessible public social assistance programs [29]. As a result, healthcare insurance may be limited, which may directly affect healthcare access and subsequent PrEP access.…”