Understanding Retention in the HIV Pre-Exposure Prophylaxis Cascade Among Cisgender Women

Jamie A. Burns; Shawnika J. Hull; Aisha Inuwa; Patricia Moriarty; Rachel K. Scott

doi:10.1089/apc.2023.0009

Understanding Retention in the HIV Pre-Exposure Prophylaxis Cascade Among Cisgender Women

Jamie A. Burns, Shawnika J. Hull, Aisha Inuwa, Patricia Moriarty, Rachel K. Scott

School of Communication and Information, Communication

Rutgers, The State University

Research output: Contribution to journal › Article › peer-review

Abstract

HIV remains a significant public health concern in the United States, with 34,800 new cases diagnosed in 2019; of those, 18% were among women. Oral pre-exposure prophylaxis (PrEP) with daily tenofovir disoproxil fumarate/emtricitabine is effective and safe, reducing HIV transmission by up to 92% in women. Though studies demonstrate low rates of PrEP adherence among cisgender women prescribed oral PrEP, little is known about the factors that shape PrEP continuation among them. This study focuses on understanding the experiences of cisgender women who have initiated PrEP to gain insight into the factors that shape PrEP continuation. We conducted semi-structured interviews with (N = 20) women who had been prescribed oral PrEP. Interviews were guided by the social-ecological framework to identify multilevel factors affecting PrEP continuation; we specifically examined the experience of engagement and retention in the PrEP cascade. We recruited women who had been prescribed oral PrEP by a government-sponsored sexual health center or a hospital-based family planning clinic in Washington, DC. Factors facilitating PrEP continuation included a positive emotional experience associated with PrEP use, high perceived risk of HIV acquisition, and high-quality communication with health care providers. The most common reason for PrEP discontinuation was low perceived HIV risk (n = 11). Other factors influencing discontinuation were side effects, a negative emotional experience while using PrEP, and negative interactions with the health care system. This study underscores the importance of specific multi-level factors, including the provision of high-quality communication designed to resonate with women and shared decision making between women and their health care providers.

Original language	American English
Pages (from-to)	205-211
Number of pages	7
Journal	AIDS patient care and STDs
Volume	37
Issue number	4
DOIs	https://doi.org/10.1089/apc.2023.0009
State	Published - Apr 1 2023

ASJC Scopus subject areas

Public Health, Environmental and Occupational Health
Infectious Diseases

Keywords

HIV
HIV Infections/prevention and control
adherence
pre-exposure prophylaxis
women

Access to Document

10.1089/apc.2023.0009

Cite this

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abstract = "HIV remains a significant public health concern in the United States, with 34,800 new cases diagnosed in 2019; of those, 18% were among women. Oral pre-exposure prophylaxis (PrEP) with daily tenofovir disoproxil fumarate/emtricitabine is effective and safe, reducing HIV transmission by up to 92% in women. Though studies demonstrate low rates of PrEP adherence among cisgender women prescribed oral PrEP, little is known about the factors that shape PrEP continuation among them. This study focuses on understanding the experiences of cisgender women who have initiated PrEP to gain insight into the factors that shape PrEP continuation. We conducted semi-structured interviews with (N = 20) women who had been prescribed oral PrEP. Interviews were guided by the social-ecological framework to identify multilevel factors affecting PrEP continuation; we specifically examined the experience of engagement and retention in the PrEP cascade. We recruited women who had been prescribed oral PrEP by a government-sponsored sexual health center or a hospital-based family planning clinic in Washington, DC. Factors facilitating PrEP continuation included a positive emotional experience associated with PrEP use, high perceived risk of HIV acquisition, and high-quality communication with health care providers. The most common reason for PrEP discontinuation was low perceived HIV risk (n = 11). Other factors influencing discontinuation were side effects, a negative emotional experience while using PrEP, and negative interactions with the health care system. This study underscores the importance of specific multi-level factors, including the provision of high-quality communication designed to resonate with women and shared decision making between women and their health care providers.",

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Understanding Retention in the HIV Pre-Exposure Prophylaxis Cascade Among Cisgender Women

Abstract

ASJC Scopus subject areas

Keywords

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