Intention to Initiate HIV Pre-exposure Prophylaxis Among Cisgender Women in a High HIV Prevalence U.S. City

Rachel K. Scott, Shawnika J. Hull, Jim C. Huang, Peggy P. Ye, Pamela Lotke, Jason Beverley, Patricia Moriarty, Dhikshitha Balaji, Allison Ward, Jennifer Holiday, Ashley R. Brant, Rick Elion, Adam J. Visconti, Megan Coleman

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Our objective was to identify the individual, interpersonal, community, health-system, and structural factors that influence HIV pre-exposure prophylaxis (PrEP) initiation among cisgender women seeking sexual and reproductive health care in a high HIV prevalence community to inform future clinic-based PrEP interventions. Methods: We collected anonymous, tablet-based questionnaires from a convenience sample of cisgender women in family planning and sexual health clinics in the District of Columbia. The survey used the lens of the socio-ecological model to measure individual, interpersonal, community, institutional, and structural factors surrounding intention to initiate PrEP. The survey queried demographics, behavioral exposure to HIV, perceived risk of HIV acquisition, a priori awareness of PrEP, intention to initiate PrEP, and factors influencing intention to initiate PrEP. Results: A total of 1437 cisgender women completed the survey. By socio-ecological level, intention to initiate PrEP was associated with positive attitudes toward PrEP (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.13–2.15) and higher self-efficacy (OR, 1.32; 95% CI, 1.02–1.72) on the individual level, perceived future utilization of PrEP among peers and low fear of shame/stigma (OR, 1.65; 95% CI, 1.33–2.04) on the community level, and having discussed PrEP with a provider (OR. 2.39; 95% CI, 1.20–4.75) on the institutional level. Conclusion: Our findings highlight the importance of multilevel, clinic-based interventions for cisgender women, which promote sex-positive and preventive PrEP messaging, peer navigation to destigmatize PrEP, and education and support for women's health medical providers in the provision of PrEP services for cisgender women.

Original languageAmerican English
Pages (from-to)541-550
Number of pages10
JournalWomen's Health Issues
Volume33
Issue number5
DOIs
StatePublished - Sep 1 2023
Externally publishedYes

ASJC Scopus subject areas

  • Health(social science)
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health
  • Maternity and Midwifery

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