US Black cisgender women and pre-exposure prophylaxis for human immunodeficiency virus prevention: A scoping review

Abstract

Background: Black cisgender women in the United States experience a disproportionate burden of human immunodeficiency virus acquisition. Pre-exposure prophylaxis is an effective oral daily medication that reduces the risk of human immunodeficiency virus through sex by 99% when taken as prescribed. However, less than 2% of eligible Black cisgender women take pre-exposure prophylaxis. The purpose of this scoping review was to describe the types of research studies done in this area, gaps in knowledge, and potential areas of research needed to increase pre-exposure prophylaxis use among Black cisgender women in the United States. Methods: We conducted our search in MEDLINE (PubMed), Embase (Elsevier), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), and Scopus (Elsevier) using a combination of keywords and database-specific subject headings for the following concepts: pre-exposure prophylaxis, African American/Black or minority, and women. We used the Joanna Briggs Institute’s Reviewers’ Manual process for Scoping Reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews to ensure comprehensive and standardized reporting of each part of the review. Results: Fifty-nine studies were included in the final review. Results of the study were classified according to the three phases of the Human Immunodeficiency Virus Prevention Cascade—demand side, supply side, and adherence and retention. The majority of studies ( n = 24, 41%) were cross-sectional quantitative surveys and 43 (34%) focused on the demand-side phase of the Human Immunodeficiency Virus Prevention Cascade. Fifty-eight percent of studies either assessed women’s pre-exposure prophylaxis knowledge, attitudes, and intentions to use, or assessed perceived barriers and facilitators. Seven studies (12%) tested pre-exposure prophylaxis uptake and adherence among Black cisgender women. Conclusion: This review found multiple missed opportunities to increase women’s demand for pre-exposure prophylaxis and health care provider screening and referral for pre-exposure prophylaxis. Additional studies are needed to effectively assess pre-exposure prophylaxis uptake and adherence among Black cisgender women.

UPDOs Protective Styles, a Multilevel Intervention to Improve Pre-exposure Prophylaxis Uptake Among Black Cisgender Women: Pretest–Posttest Evaluation

“…Upon full completion of training, stylists received a certificate of completion and "Ask Me about PrEP" signage for their beauty salons to facilitate conversations with women. Second, together with the community, an edutainment series (The Wright Place) was co-developed with Black women and an established community advisory council (Randolph et al, 2022). The series uses culturally and socially relevant stories to highlight key messages about (a) HIV, (b) PrEP, and (c) Black women's social contributors to health.…”

“…This multicomponent, mixedmethods study used a community-engagement approach to develop and pilot test a salon-based intervention, UPDOs. Study procedures were previously reported (Randolph et al, 2022). Eligibility criteria included (a) age 18 years or older, (b) frequency of visiting the salon at least every 2 weeks, (c) self-identification as Black or African American, (d) self-identification as a woman, and (e) ability to speak and read English.…”

“…Various modes of education, such as eHealth and motivational interviewing, have successfully increased knowledge and interest in taking PrEP (Bond & Ramos, 2019;Dale, 2020;Teitelman et al, 2020Teitelman et al, , 2021. However, in a recent scoping review, most studies assessed knowledge, attitudes, and intention but did not implement interventions to change knowledge, attitudes, or practices (Conley et al, 2022). Experimental and observational studies introducing culturally responsive innovative interventions are needed.…”