TY - JOUR
T1 - Intention to Initiate HIV Pre-exposure Prophylaxis Among Cisgender Women in a High HIV Prevalence U.S. City
AU - Scott, Rachel K.
AU - Hull, Shawnika J.
AU - Huang, Jim C.
AU - Ye, Peggy P.
AU - Lotke, Pamela
AU - Beverley, Jason
AU - Moriarty, Patricia
AU - Balaji, Dhikshitha
AU - Ward, Allison
AU - Holiday, Jennifer
AU - Brant, Ashley R.
AU - Elion, Rick
AU - Visconti, Adam J.
AU - Coleman, Megan
N1 - Publisher Copyright: © 2023 The Authors
PY - 2023/9/1
Y1 - 2023/9/1
N2 - 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.
AB - 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.
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U2 - 10.1016/j.whi.2023.05.009
DO - 10.1016/j.whi.2023.05.009
M3 - Article
C2 - 37479630
SN - 1049-3867
VL - 33
SP - 541
EP - 550
JO - Women's Health Issues
JF - Women's Health Issues
IS - 5
ER -