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Awareness and Intent to Use Pre-exposure Prophylaxis (PrEP) Among African American Women in a Family Planning Clinic

Journal of Racial and Ethnic Health Disparities volume 7, pages 550–554 (2020)Cite this article

Abstract

Due to the gap between cisgender women eligible for and those accessing pre-exposure prophylaxis (PrEP) for HIV prevention, it is critical to understand knowledge of and attitudes toward PrEP among HIV-vulnerable women. PrEP utilization is particularly low among African American women in the USA. Family planning clinics provide key access points to reach HIV-vulnerable African American women as well as to translate research findings into clinical practice. Our study aimed to (1) describe the awareness of and interest in PrEP among African American cisgender women attending a family planning clinic and (2) document the barriers and facilitators to PrEP uptake among these women. A cross-sectional survey was conducted with sexually active African American women of reproductive age attending a family planning clinic. Descriptive statistics were used to characterize the sample, and bivariate analysis was used to detect difference between categorical and outcome variables. In our survey (N = 109), over 80% of participants listed not knowing PrEP was available as the primary reason for not currently taking PrEP. Seventy percent reported they would probably or definitely like to take PrEP – demonstrating that barriers to uptake might stem from knowledge deficits rather than attitudes toward prevention. Study findings have the potential to inform strategies to increase awareness of PrEP as an HIV prevention option as well as to equip women with greater self-efficacy to access PrEP in family planning settings.

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References

  1. PEPFAR. The U.S. President’s Emergency Plan for AIDS Relief Five-Year Strategy. Washington, DC. Published 2009. Accessed.

  2. Auerbach JD, Hoppe TA. Beyond “getting drugs into bodies”: social science perspectives on pre-exposure prophylaxis for HIV. J Int AIDS Soc. 2015;18:19983.

    Article  Google Scholar 

  3. Prevention CfDCa. PrEP 101. In: National Center for HIV/AIDS VH, STD, and TB Prevention, ed. Atlanta, GA 2019

  4. Koren DE, Nichols JS, Simoncini GM. HIV pre-exposure prophylaxis and women: survey of the knowledge, attitudes, and beliefs in an urban obstetrics/gynecology clinic. AIDS Patient Care STDs. 2018;32(12):490–4.

    Article  Google Scholar 

  5. Gavin L, Moskosky S, Carter M, et al. Providing quality family planning services: recommendations of CDC and the US Office of population affairs. Morbidity Mortality Weekly Report: Recommendations and Reports. 2014;63(4):1–54.

    Google Scholar 

  6. Bush S, Magnuson D, Rawlings MK, Hawkins T, McCallister S, Mera GR. Racial characteristics of FTC/TDF for pre-exposure prophylaxis (PrEP) users in the US. ASM Microbe/ICAAC. 2016.

  7. Scribner R, Theall KP, Simonsen N, Robinson W. HIV risk and the alcohol environment: advancing an ecological epidemiology for HIV/AIDS. Alcohol Research & Health. 2010;33(3):179.

    Google Scholar 

  8. Adimora AA, Schoenbach VJ. Social determinants of sexual networks, partnership formation, and sexually transmitted infections. In: The new public health and STD/HIV prevention. Berlin: Springer; 2013. p. 13–31.

    Chapter  Google Scholar 

  9. Adimora AA, Schoenbach VJ. Contextual factors and the black-white disparity in heterosexual HIV transmission. Epidemiology. 2002;13(6):707–12.

    Article  Google Scholar 

  10. Seidman D, Weber S. Integrating preexposure prophylaxis for human immunodeficiency virus prevention into women's health care in the United States. Obstet Gynecol. 2016;128(1):37–43.

    CAS  Article  Google Scholar 

  11. DHHS. Title X family planning: HIV prevention in family planning. U.S. Department of Health and Human Services, Office of Population Affairs Web site. http://www.hhs.gov/opa/title-x-family-planning/initia tives-and-resources/hiv-prevention-and-integration/. Published 2015b. Accessed.

  12. Seidman D, Weber S, Carlson K, Witt J. Family planning providers' role in offering PrEP to women. Contraception. 2018;97(6):467–70.

    Article  Google Scholar 

  13. Seidman D, Carlson K, Weber S, Witt J, Kelly PJ. United States family planning providers' knowledge of and attitudes towards preexposure prophylaxis for HIV prevention: a national survey. Contraception. 2016;93(5):463–9.

    Article  Google Scholar 

  14. Auerbach JD, Kinsky S, Brown G, Charles V. Knowledge, attitudes, and likelihood of pre-exposure prophylaxis (PrEP) use among US women at risk of acquiring HIV. AIDS Patient Care STDs. 2015;29(2):102–10.

    Article  Google Scholar 

  15. Garfinkel DB, Alexander KA, McDonald-Mosley R, Willie TC, Decker MR. Predictors of HIV-related risk perception and PrEP acceptability among young adult female family planning patients. AIDS Care. 2017;29(6):751–8.

    Article  Google Scholar 

  16. PN GL, Warren-Jeanpiere L, Experton LS, Young MA, Stigma KS. Partners, providers and costs: potential barriers to PrEP uptake among US women. J AIDS Clin Res. 2017;8(9).

  17. Hsieh H-F, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277–88.

    Article  Google Scholar 

  18. Division of HIV/AIDS Prevention NCfHA, Centers for Disease Control and Prevention. HIV and African Americans. 2019.

  19. Fletcher FE, Fisher C, Buchberg MK, Floyd B, Hotton A, Ehioba A, et al. “Where did this [PrEP] come from?” African American mother/daughter perceptions related to adolescent Preexposure prophylaxis (PrEP) utilization and clinical trial participation. Journal of Empirical Research on Human Research Ethics. 2018;13(2):173–84.

    Article  Google Scholar 

  20. Frost JJ, Gold RB, Bucek A. Specialized family planning clinics in the United States: why women choose them and their role in meeting women's health care needs. Womens Health Issues. 2012;22(6):e519–25.

    Article  Google Scholar 

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Funding

Support for this study was provided by the Society of Family Planning Research Fund (grant SFP RF11-II5-2).

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Affiliations

  1. Division of Adolescent Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA

    Amy K. Johnson

  2. Department of Pediatrics, Northwestern Feinberg School of Medicine, Chicago, IL, USA

    Amy K. Johnson

  3. AIDS Foundation of Chicago, Chicago, IL, USA

    Amy K. Johnson & Jessica Terlikowski

  4. Department of Health Behavior, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA

    Faith E. Fletcher

  5. Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL, USA

    Emily Ott, Marisa Wishart & Sadia Haider

  6. The Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA

    Eleanor E. Friedman

Authors
  1. Amy K. Johnson
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  2. Faith E. Fletcher
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  3. Emily Ott
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  4. Marisa Wishart
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  5. Eleanor E. Friedman
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  6. Jessica Terlikowski
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  7. Sadia Haider
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Corresponding author

Correspondence to Amy K. Johnson.

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The authors declare that they have no conflict(s) of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Ann & Robert H. Lurie Children’s Hospital Institutional Review Board, IRB2017–1410) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Johnson, A.K., Fletcher, F.E., Ott, E. et al. Awareness and Intent to Use Pre-exposure Prophylaxis (PrEP) Among African American Women in a Family Planning Clinic. J. Racial and Ethnic Health Disparities 7, 550–554 (2020). https://doi.org/10.1007/s40615-019-00683-9

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  • DOI: https://doi.org/10.1007/s40615-019-00683-9

Keywords

  • African American
  • Family planning
  • HIV prevention
  • Pre-exposure prophylaxis
  • Women