Abstract

Atlanta has been identified as an HIV "hot spot" for Black women and ranks 5th in the US with new infections. Yet little is known about PrEP eligibility or interest among young Black women in Atlanta. A convenience sample of 1,261 Black women (ages 14-24 years) were recruited from two settings: community venues and sexual health clinics. They provided self-reported sexual behavior data and specimens for laboratory testing for chlamydia (CT) and gonorrhea (GC) infections. For each woman, the number of key self-reported behavioral HIV risk factors was calculated (0-6 factors for the clinic sample, 0-3 factors for the community sample). A single item assessed PrEP interest in the community sample only. Bacterial STI positivity, an indicator for PrEP eligibility, was 20.5% (17.1% CT, 6.3% GC) and 20.9% (18.8% CT, 5.2% GC) for the clinic and community samples, respectively. Of the 144 STI positive women from the clinic sample, 20.1% reported no behavioral risk indicators and 47.2% reported > 2 behavioral indicators. Of the 117 STI positive women from the community sample, 21.4% reported no behavioral risk indicators. 60.7% of the community sample reported they would be likely or very likely to use PrEP if available. Young Black women in Atlanta, whether sampled from community or sexual health settings, are at substantial risk for HIV infection and meet several PrEP eligibility criteria. Scaling up PrEP among women in Atlanta could have significant implications for HIV in this high burden region.

Highlights

  • Overall, individuals in the US have a 1 in 99 chance of being diagnosed with HIV at some point in their life [1]

  • Racial and geographic disparities are magnified in women; while Black men have over 7 times the lifetime risk of an HIV diagnosis of White men, 1 in 48 Black women are diagnosed with HIV over their lifetime, nearly 20 times the risk for White women [1]

  • Southern states account for nearly half of new HIV diagnoses despite having only 37% of the population [3], and of all US women diagnosed with HIV in 2015, 56% of new HIV diagnoses were among women living in the South [4]

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Summary

Introduction

Individuals in the US have a 1 in 99 chance of being diagnosed with HIV at some point in their life [1]. Underlying this overall statistic are significant racial and geographic disparities. Atlanta has been identified as an HIV “hot spot” for Black women, and currently ranks 5th in the nation for new HIV infections [5]. Atlanta has been identified as an HIV “hot spot” for Black women and ranks 5th in the US with new infections. Little is known about PrEP eligibility or interest among young Black women in Atlanta

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