Primary Submission Category: Environmental factors
Exploring predictors of the decisions to initiate PrEP among cisgender Black women
Authors: Mandy Hill Sarah Sapp Shadawn McCants Jeffrey Campbell Diane Santa Maria
Presenting Author: Mandy Hill*
Background: Black women account for 67% of new HIV diagnoses among all women in the South. Optimal progress toward ending the HIV epidemic require strategies that will interrupt transmission pathways among women in HIV hotspot locations. This qualitative work explores predictors of the decision to initiate pre-exposure prophylaxis (PrEP) among cisgender Black women.
Methods: Qualitative methods were used to explore how culture, race, and gender influence individual decisions to use PrEP among 20 Black women through focus group discussions.
Results: Themes identified from focus groups during an interim data analysis highlighted PrEP knowledge, public PrEP awareness, awareness of peers who take PrEP, self-advocacy with providers about health, and PrEP accessibility. Several participants highlighted that their PrEP knowledge was rooted in media campaigns, which indirectly conveyed that PrEP was not for cis Black women. One participant stated, ‘What I know of PrEP is the one commercial where they said PrEP has not been studied in cis women, which I feel was a little shady.’ In regards to awareness of peers who take PrEP, one participant stated, ‘“Most of my friends who are gay men take PrEP, but that is as much as I know about it. None of my female friends hear about it, know about it, and if they do, they think of it as like the ‘gay drug’…taking the ‘gay man’s drug’ would be admitting to the community that I have sex with gay or bisexual men.”
Conclusions: Study findings point to gaps in media marketing regarding who can benefit from PrEP. Healthcare providers should be aware that some of their patients may perceive that PrEP is not for them. This information elucidates the urgency of provider-led sexual health discussions to bridge the gap between PrEP-eligibility and initiation among cisgender Black women.