Using Participatory Methods to Assess PrEP Interest and Uptake Among Young People Living in the Southeastern US: A Mixed Methods Assessment

Stoner, Marie; Bhushan, Nivedita L.; Maragh-Bass, Allysha C.; Mitchell, John T.; Riggins, Linda; Walker, Maleka; LeMasters, Katherine; Reese, Bianka M.; Dearing, Aissa; Debnam, Summer; Golin, Carol E.; Lightfoot, Alexandra F.; Pettifor, Audrey

doi:10.1007/s10461-021-03519-y

Cited by 4 publications

(5 citation statements)

References 23 publications

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“…This underscores the need for more interventions which (a) address sexual health and genderaffirming needs holistically and not simply HIV prevention, and (b) move towards more interventions that incorporate more meaningful concepts besides perceived HIV risk for youth regardless of their sexual orientation or gender identity. Youth do not accurately assess their HIV risk and find the language of risk stigmatizing [32][33][34].…”

Section: Discussionmentioning

confidence: 99%

“I Had No Idea about This:” A Mixed-Methods Exploration of Sexual Health and HIV Prevention Needs among Black Youth in a Southern City

Maragh-Bass,

Mitchell,

Stoner

et al. 2024

Adolescents

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HIV disparities continue to persist among Black youth in the South. We conducted quantitative surveys (N = 83) and follow-up qualitative interviews (n = 13) to assess sexual health needs including but not limited to Pre-Exposure Prophylaxis (PrEP) awareness. Participants all identified as Black; most survey respondents identified as being assigned female sex at birth and heterosexual. Both qualitatively and quantitatively, knowledge about HIV and PrEP and engagement in sexual health preventive behaviors was low. Participants described a need for more comprehensive sexual health education at younger ages and more routinized HIV testing. The latter was recommended even for people with a low perceived risk of HIV. Future studies should explore how to tailor communication to youth of color specifically and understand nuances of experiences they may have based on their sexual orientation and gender identity to promote engagement in sexual health preventive care, including but not limited to HIV prevention and PrEP uptake. The findings suggest that comprehensive sexual care that provides education on HIV, STI, and pregnancy prevention is critical for youth experiencing inequities in a Southern city context.

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Section: Discussionmentioning

confidence: 99%

“I Had No Idea about This:” A Mixed-Methods Exploration of Sexual Health and HIV Prevention Needs among Black Youth in a Southern City

Maragh-Bass,

Mitchell,

Stoner

et al. 2024

Adolescents

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“…With the advent of options like long-acting injectables, there are increasing and more diverse options for PrEP. Given the well documented challenges of adherence to daily PrEP formulations in our own and other studies [17], nondaily long-acting PrEP formulations have the potential to revolutionize HIV prevention provided that its rollout targets the specific experiences and needs of YSGM of color .…”

Section: Newer Preexposure Prophylaxis Formulations and Communities E...mentioning

confidence: 98%

“…An oft-cited barrier to PrEP uptake is perceived judgement from healthcare providers, which prevents candid conversations about sexual health including but not limited to PrEP [16][17][18][19]. Research shows that poor client-provider communication leads to negative client outcomes, including nonadherence to medical treatment, poor client satisfaction, and lack of trust in providers [18].…”

Section: Newer Preexposure Prophylaxis Formulations and Communities E...mentioning

confidence: 99%

New preexposure prophylaxis options need updated counseling approaches: reframing ‘risk’ in HIV prevention counseling for young sexual and gender minorities of color

Maragh-Bass

Stoner

Castellanos-Usigli

et al. 2023

Aids

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“…[4][5][6] Adolescent girls and young women (AGYW) and their providers identify several barriers to PrEP use, including limited knowledge and awareness of PrEP eligibility, low self-risk perception, and limited advertising to Black AGYW. [7][8][9][10][11][12][13] Provider challenges include familiarity with PrEP guidelines, competing demands, discomfort assessing sexual health, low provider-perceived client risk, maintaining AGYW confidentiality, and adherence concerns. 8,14,15 Our previous work among Black AGYWand providers illustrates that these barriers are amplified in the Deep South, and sexual health conversations are not routine.…”

mentioning

confidence: 99%

“…However, PrEP uptake is not equitably distributed 4–6 . Adolescent girls and young women (AGYW) and their providers identify several barriers to PrEP use, including limited knowledge and awareness of PrEP eligibility, low self-risk perception, and limited advertising to Black AGYW 7–13 . Provider challenges include familiarity with PrEP guidelines, competing demands, discomfort assessing sexual health, low provider-perceived client risk, maintaining AGYW confidentiality, and adherence concerns 8,14,15 …”

mentioning

confidence: 99%

“Nobody Wants to Have Conversation About HIV.” A Thematic Analysis of in-Depth Interviews With Black Adolescent Women and Providers About Strategies for Discussing Sexual Health and HIV Prevention

Hill,

Pratt,

Elopre

et al. 2024

Sexual Trans Dis

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Background Black adolescent girls and young women (AGYW) in the U.S. Southeast are disproportionately burdened by HIV. Infrequent assessment of sexual health in clinical encounters may contribute to low PrEP uptake for this population. This study explores Black AGYW and providers’ perspectives on engaging in discussions about sexual health, including PrEP. Methods In-depth interviews (IDIs) were conducted with Black AGYW ages 14-24 and healthcare providers (MD, DO, NP, PA) who self-reported caring for Black AGYWs in Alabama. IDIs were grounded in Andersen’s Behavioral Model of Health Service Utilization to explore barriers and facilitators to sexual health discussions. After separate analyses, AGYW and provider IDIs were aggregated and reanalyzed using thematic analysis to identify themes related to their views on ways to improve Black AGYW engagement in sexual health discussions while in clinical settings. Results Twelve Black AGYW and 11 providers completed IDIs. Client median age was 21, representing nine Alabama counties. Providers were predominately non-Hispanic White (82%), female (73%), and physicians (64%). Themes about ways to improve sexual health discussions included: 1) Improve sexual health education for providers and adolescents; 2) Normalize conversations in clinical settings; 3) Engage communities to continue these conversations outside of clinical settings. Conclusions Sexual health and HIV prevention discussions with Black AGYW are not occurring. This study is one of the first to to identify and highlight Black AGYW and provider-identified shared strategies for improving these discussions. Operationalizing these strategies is crucial to facilitating these discussions.

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Using Participatory Methods to Assess PrEP Interest and Uptake Among Young People Living in the Southeastern US: A Mixed Methods Assessment

Cited by 4 publications

References 23 publications

“I Had No Idea about This:” A Mixed-Methods Exploration of Sexual Health and HIV Prevention Needs among Black Youth in a Southern City

“I Had No Idea about This:” A Mixed-Methods Exploration of Sexual Health and HIV Prevention Needs among Black Youth in a Southern City

New preexposure prophylaxis options need updated counseling approaches: reframing ‘risk’ in HIV prevention counseling for young sexual and gender minorities of color

“Nobody Wants to Have Conversation About HIV.” A Thematic Analysis of in-Depth Interviews With Black Adolescent Women and Providers About Strategies for Discussing Sexual Health and HIV Prevention

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