Perceptions of and preferences for PrEP use among African American women and providers in the U.S. South: a qualitative study
Elizabeth M. Waldron, Georgia R. Goodman, Alexa Rivas, Corilyn Ott, Abigail Blyler, Victoria McDonald, Marquetta Campbell, Eric Underwood, Aharisi Bonner, Jenni M. Wise, Latesha Elopre, Kachina Kudroff, Douglas Krakower, Kenneth Sherr, Mirjam-Colette Kempf, Christina Psaros
Abstract
OBJECTIVE: African American (AA) women in the U.S. South experience significant HIV incidence, and efforts to support antiretroviral pre-exposure prophylaxis (PrEP) uptake and maintenance among this group have been insufficient. This study aimed to explore perceptions, attitudes, and implementation preferences surrounding PrEP use for AA women in the U.S. South. METHODS AND MEASURES: = 20) in Federally Qualified Health Centers and HIV clinics in Alabama. The research team employed directed qualitative content analysis to analyze interview data. RESULTS: Five themes emerged: a) inconsistent access to PrEP and PrEP knowledge, b) need for improving low PrEP awareness, c) managing hesitancy to prescribe or use PrEP, d) perceived HIV vulnerability and inherent stigma, and e) normalizing PrEP as part of routine sexual healthcare to increase uptake and maintenance. Interviews revealed an openness towards PrEP as an HIV prevention strategy for AA, cisgender women in Alabama. CONCLUSION: Improving PrEP uptake and maintenance among AA women in the U.S. South must go beyond increasing awareness to improving PrEP access and trust through visibility of AA women's PrEP use and incorporating PrEP education and services into routine sexual healthcare.