Preexposure prophylaxis (PrEP) with optimal adherence has demonstrated efficacy in reducing HIV incidence in women. Black women are disproportionately burdened by the HIV epidemic, accounting for more than half of all new HIV cases in women, thereby making PrEP an ideal prevention strategy for this group. However, to date, PrEP uptake by women in the United States has been slow. Further domestic research is needed to understand the multilevel factors related to PrEP awareness, uptake, and implementation in Black women. Our purpose was to review the current status of HIV prevention in Black women. We summarize clinical trials germane to federal approval of PrEP; discuss important PrEP studies focused on women, including non-oral options; and review multilevel barriers to PrEP uptake. Lastly, we discuss the use of an integrated theoretical framework to organize multilevel factors related to PrEP uptake by Black women in order to guide intervention development.

The purpose of this systematic review was to assess the state of adherence to HIV care such as HIV medication and appointment adherence among Black women in the United States. After a systematic search of CINAHL, PubMed, EMBASE, and clinicialtrials.gov, 26 studies and two ongoing trials met inclusion criteria. Psychosocial factors such as intersectional stigmas and depression were among the salient factors associated with adherence-to-care behaviors in women living with HIV (WLWH). In addition, interpersonal factors such as social support and the patient-provider relationship were frequently associated with adherence-to-care behaviors. No culturally relevant interventions for Black WLWH were found in the literature, but one ongoing trial that was developed specifically for Black WLWH seemed promising. Considering the dearth of tailored interventions, more gender-specific and culturally relevant interventions are urgently needed to improve adherence-to-care behaviors and optimize health outcomes for Black WLWH.

Galactosaemia (galactose-1-phosphate uridyltransferase deficiency) is a pan-ethnic autosomal recessive disorder of galactose metabolism, with an estimated prevalence of 1 in 40-50000. In this pilot study, we aimed to examine the impact of galactosaemia on patients' everyday emotions, schooling, work, friendships, communication, physical activities, self-esteem and body image. We interviewed all patients with galactosaemia who attended our clinic over 2002-2003, aged 6 years and above (n = 13, age range 6-23 years) and, when possible, their parents (n = 12). The questionnaire used was based on an adaptation of the Minneapolis-Manchester QOL survey and the Australian Child Health Questionnaire. Interpersonal problems, bullying and having a hard time getting along with others, excessive anger on a regular basis, sleeping problems and problems with academic achievement, particularly with mathematics, were common. Significant differences were found between patients' and parents' perceptions, with 7/13 patients nominating the dietary restrictions and 4/7 parents nominating long-term issues as the most distressing aspect of having galactosaemia. In addition, most patients felt they were treated differently from their siblings by their parents, yet all parents felt they treated their child with galactosaemia as their other children. We conclude that galactosaemia has a significant impact on the psychosocial aspects of patients' lives. Clinicians should be aware that parents and patients can have different perspectives of the impact of galactosaemia on quality of life.

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The Health Belief Model (HBM) has been widely used as a framework to explain health behaviors in diverse populations, but little HBM research has focused on HIV-infected women and their increased risks for cervical cancer. We used Champion's Health Belief Model and Self-Efficacy scales to assess relationships between Pap test adherence and constructs of the HBM among 300 HIV-infected women. In addition, we assessed the relationship between HPV and cervical cancer knowledge and key HBM concepts. Participants reported low levels of knowledge regarding risk for cervical cancer and HPV. They perceived lower personal risk for cervical cancer. Women with higher perceived self-efficacy and lower perceived barrier scores reported better Pap test adherence. Findings indicate that HIV-infected women are not aware of the risk for cervical cancer and may not take preventive actions. Further research is needed to identify the full range of factors that impact adherence to cervical cancer screening.