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Avoiding Shots in the Dark: Learning from the Past To Inform the Implementation of Long-Acting Injectable Pre-Exposure Prophylaxis for Black American Cisgender Women

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Abstract

The FDA’s approval of long-acting injectable cabotegravir pre-exposure prophylaxis (LAI PrEP) as an alternative to daily oral PrEP represents a crucial development in HIV prevention, particularly for American Black cisgender women who face high HIV-1 risks. Yet, uptake may be hindered by racial and gender inequities. Addressing these requires learning from the roll-out of oral PrEP, creating culturally tailored PrEP campaigns, and enhancing provider training to meet Black women’s needs. Tools for discussing PrEP within personal relationships and product preference research tailored to Black women’s needs are essential for effective LAI PrEP delivery. Deliberative implementation of LAI PrEP must employ strategies that are community-sensitive, -responsive, and -inclusive. It should prioritize the incorporation of Black women’s voices in decision-making and should promote community-led strategies. By addressing historical injustices and fostering trust, healthcare systems can enhance LAI PrEP uptake by Black women. Emphasizing a community-centered approach that ensures health equity and acknowledges the crucial role that social media and Black-led organizations play in promoting PrEP awareness and adoption within Black communities is necessary for successful implementation.

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Authors and Affiliations

  1. Boston College School of Social Work, 140 Commonwealth Avenue, 02467-1037, Chestnut Hill, MA, USA

    Whitney C. Irie

  2. The Fenway Institute, Fenway Health, Boston, MA, USA

    Whitney C. Irie & Kenneth Mayer

  3. Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Kenneth Mayer

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Correspondence to Whitney C. Irie.

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Competing Interests

WCI and KHM have received funds to develop and deliver medical education related to PrEP. WCI receives medical education grants related to PrEP from ViiV Healthcare. KHM has conducted research funded by grants to Fenway Health from Gilead Sciences and Merck. He has served on Scientific Advisory Boards for Gilead Sciences and Merck and has received personal funds for development of educational content for UpToDate, Inc.

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Irie, W.C., Mayer, K. Avoiding Shots in the Dark: Learning from the Past To Inform the Implementation of Long-Acting Injectable Pre-Exposure Prophylaxis for Black American Cisgender Women. AIDS Behav (2024). https://doi.org/10.1007/s10461-024-04340-z

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