Black Women’s Sexual Well-being in the Age of Pre-Exposure Prophylaxis (PrEP): a Systematic Review of the Literature

Abstract

Purpose of ReviewBlack women’s sexual well-being is predicated upon having the autonomy, resources, and access to define, explore, and safely enjoy their sexuality and intimacy. Black cisgender and transgender women have been placed at disproportional risk for HIV due to structural and health specific inequities. Pre-exposure prophylaxis (PrEP), an effective biomedical intervention, reduces HIV transmission from sex or injection drug use by 99%, however the uptake of PrEP remains low among Black cisgender and transgender women. Using the PRISMA technique, we conducted a review of literature on Black women, cisgender and transgender, and PrEP. We used Google Scholar and PubMed to conduct the search.Recent FindingsOur initial search garnered 2,221 sources across the two databases. However, n = 197 articles were included in this review based on the screening process and our inclusion criteria. Socio-cultural factors, provider factors, low HIV risk awareness, limited PrEP awareness and knowledge, communication, motivation, concerns about PrEP, barriers, and sexual agency, power, and pleasure may impact utilization of PrEP among Black transgender and cisgender women. However, facilitators were highlighted as well as interventions, though limited.SummaryTo adequately meet the needs of Black women and increase PrEP uptake, there is a need to address these factors that may impact utilization and develop effective interventions for Black women surrounding PrEP.