Perspectives on HIV Prevention Among Urban Black Women: A Potential Role for HIV Pre-Exposure Prophylaxis

Abstract

Limited data exist regarding attitudes and acceptability of topical and oral HIV pre-exposure prophylaxis (PrEP) among US black women. This investigation explored interest in HIV chemoprophylaxis and modes of use. Five focus groups enrolled 26 black women recruited from an inner-city community health center and affiliated HIV testing sites. Thematic analysis utilized Atlas.ti. Most women expressed interest in PrEP, as many reported condom failure concerns. Most women preferred a pill formulation to intravaginal gel because of greater perceived privacy and concerns about vaginal side effects and gel leakage. Women who had taken pills previously advocated daily dosing and indicated adherence concerns about episodic or post-coital PrEP. Many women desired prophylactic strategies that included partner testing. Urban black women are interested in utilizing PrEP; however, misgivings exist about gel inconvenience and potential side effects for themselves and their partners. Most women preferred oral PrEP, dosed daily.

The Potential of Pre-Exposure Prophylaxis for Women in Violent Relationships

“…[46][47][48] A recent focus group study of women in six US cities found that although almost none of the participants had heard of PrEP before the study took place, many said they would use PrEP if available. 46 In a study assessing attitudes toward PrEP uptake and adherence, young adult women who experienced IPV reported greater willingness to take PrEP than those who had not.…”

“…[49][50][51] Although little research on covert use of vaginal microbicides has been conducted in the United States, one focus group study of black women found that women were concerned that their partner would be able to tell when they had used vaginal gel due to increased lubrication. 47 As in the case with the female condom, preventive measures that produce immediate physical indicators of their use may make covert usage difficult for women in violent relationships; thus, oral PrEP may be preferable to the use of microbicide gel in this population.…”

Intimate Partner Violence and PrEP Acceptability Among Low-Income, Young Black Women: Exploring the Mediating Role of Reproductive Coercion

“…Among the few studies, Black women seemed to be highly interested and more accepting of PrEP than White women [19,31]; however, additional research is needed to inform PrEP implementation among this population at high risk for HIV. Thus, the aims of the current study are to: (1) describe the prevalence and associations of IPV, reproductive coercion experiences, and PrEP acceptability among urban-dwelling low-income young Black women, and (2) examine birth control sabotage and pregnancy coercion as mediators of the association between IPV and PrEP acceptability.…”

Leveraging Social Media to Explore Black Women's Perspectives on HIV Pre-exposure Prophylaxis

“…However, few PrEP-related studies have focused on U.S. women. These few studies have demonstrated low levels of PrEP awareness, but high levels of interest among women (Auerbach, Kinsky, Brown, & Charles, 2015; Flash et al, 2014; Goparaju et al, 2015). Women welcomed the idea of a user-controlled HIV prevention method, but concerns existed related to potential side effects, daily adherence, and stigma (Auerbach et al, 2015; Flash et al, 2014; Goparaju et al, 2015).…”