A Web-Based Application (UPDO’s Protective Styles-Using PrEP, Doing it for Ourselves) to Improve Knowledge, Awareness and Uptake of Pre-Exposure Prophylaxis (PrEP) among Black Women in the United States South: Protocol for Feasibility and Acceptability (Preprint)

Abstract

BACKGROUND Multi-level interventions are necessary to address the complex social contributors to health that limit Black women’s uptake of PrEP, including medical distrust, PrEP stigma, and access to equitable health care. Strategies to improve knowledge, awareness, and uptake of PrEP among Black women will be more successful if they are informed by Black women and their communities and implemented within trusted environments. Providing women with information through trusted cultural and social channels can effectively support informed decision making about PrEP for themselves and members of their social networks who are eligible for PrEP. OBJECTIVE This multilevel, mixed-methods study uses a community-engagement approach to develop and pilot test a salon-based intervention with the goal of improving knowledge and awareness of PrEP as well as PrEP stigma and uptake. METHODS There are three components of this intervention: (1) stylist training, (2) women-focused entertainment videos and modules, and (3) engagement of PrEP Navigator. First, stylist training will be provided virtually through two 2-hour training sessions delivered over two consecutive weeks. We will use a pre-post test design to examine knowledge and awareness improvement of PrEP among stylists. Upon full completion of training, stylists will receive a certificate of completion and “Ask Me about PrEP” signage for their beauty salons. Second, together with the community, we have co-developed a 4-part entertainment series (The Wright Place) that uses culturally and socially relevant stories to highlight key messages about (a) HIV, (b) PrEP, and (c) Black women’s social contributors to health. Quantitative measures will be used in a pre-post test design to examine PrEP knowledge, awareness, risk, stigma, trust, and intentions. Qualitative data will be collected to examine women’s perceptions of the usability and acceptability of the overall intervention and its implementation strategies. A video blog and educational modules providing resources and links about PrEP will be provided after each video. Third, participants will have access through an email or text message link to a PrEP Navigator who will respond to them privately to answer any questions or make referrals for PrEP as requested. RESULTS This project was funded in October 2020 by Gilead Sciences, Inc. and approved by the institutional review board in April 2021. Data collection of Phase 1 will begin October 2021. Data collection for Phase 2 will begin November 2021, with study completion by October 2022. CONCLUSIONS Multilevel interventions that consider the assets of the community have promise for promoting health among Black women who have influence within their social networks but may have low perceptions of risk. The findings of this study have the potential to be generalizable to other populations.