A Longitudinal, Qualitative Exploration of Perceived HIV Risk, Healthcare Experiences, and Social Support as Facilitators and Barriers to PrEP Adoption Among Black Women

• Published in: AIDS and behavior Vol. 25; no. 2; pp. 582 - 591
• Main Authors: Nydegger, Liesl A., Dickson-Gomez, Julia, Ko Ko, Thant
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-02-2021; Springer Nature B.V
• Subjects: African Americans; Anti-HIV Agents - therapeutic use; Barriers; Black or African American; Black people; Child; Delivery of Health Care; Disease prevention; Drug use; Female; Health behavior; Health Knowledge, Attitudes, Practice; Health Psychology; Health risks; Health services; HIV; HIV Infections - prevention & control; HIV Infections - psychology; Human immunodeficiency virus; Humans; Infant; Infectious Diseases; Knowledge; Medical research; Medicine; Medicine & Public Health; Original Paper; Patient compliance; Pre-Exposure Prophylaxis; Prophylaxis; Public Health; Qualitative research; Risk; Risk perception; Social interactions; Social Support; Transportation; Trust; Women; Womens health; HIV/AIDS; Perceived HIV risk; Medical mistrust; PrEP barriers; Black/African-American women
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-020-03015-9

Black women contract HIV at much higher rates than White or Hispanic women. Pre-exposure prophylaxis (PrEP) is an underutilized prevention tool among this population. We sought to determine participants’ interest in PrEP and facilitators and barriers to PrEP adoption. This longitudinal, qualitative study included 30 Black women (M
age
 = 32.2) interviewed 4 times over 6 months. Most participants had never heard of PrEP and a majority expressed initial interest. Barriers to PrEP initiation included low perceived HIV risk, medical mistrust, provider experiences and knowledge, negative reactions from family and friends, low perceived efficacy to adherence, and transportation. This study demonstrated actual, rather than hypothetical, PrEP interest and attitudes among Black women, and the barriers that arose over time during the study. PrEP awareness needs to be promoted among Black women and medical providers. Future research should address individual risk perception, medical mistrust, increasing social support, and decreasing transportation barriers.