Abstract
BackgroundMerely having the tools to end HIV is insufficient. Effectively ending the epidemic necessitates addressing barriers that impede engagement in biomedical and behavioral prevention and wide scale implementation and utilization of existing interventions. This qualitative study identifies suggestions for increasing access to, engagement in, and impact of HIV prevention among women living in cities in high HIV burden counties in the eastern US.MethodsData analyzed for the current study were collected via a qualitative sub-study within the HIV Prevention Trials Network Study 064 (HPTN 064), a multisite observational cohort study designed to estimate HIV incidence among women residing in communities with elevated HIV prevalence who also reported personal or partner characteristics associated with increased risk of HIV acquisition. Focus group and interview participants in the qualitative sub-study (N = 288) were from four cities in the eastern US.ResultsThematic analyses revealed four themes describing women’s most frequently stated ideas for improving prevention efforts: 1) Promote Multilevel Empowerment, 2) Create Engaging Program Content, 3) Build “Market Demand”, and 4) Ensure Accessibility. We conducted additional analyses to identify contradictory patterns in the data, which revealed an additional three themes: 1) Address Structural Risk Factors, 2) Increase Engagement via Pleasure Promotion, 3) Expand Awareness of and Access to Prevention Resources.ConclusionsFindings may be useful for enhancing women’s engagement in and uptake of behavioral and biomedical HIV prevention resources, improving policy, and addressing multilevel risk factors.Trial registrationClinicaltrials.gov: NCT00995176, prospectively registered.
Highlights
Having the tools to end Human Immunodeficiency Virus (HIV) is insufficient
The resulting development and implementation of targeted and tailored public health programs, awareness campaigns, and interventions have contributed to major accomplishments in HIV prevention, including decreases in sexual and perinatal transmission as well as increases in span and quality of life for people living with HIV/Acquired Immunodeficiency Syndrome (AIDS) (PLWHA) [3,4,5,6]
Data analyzed for the current study were collected via a qualitative sub-study within the HIV Prevention Trials Network Study 064 (HPTN 064), a multisite observational cohort study designed to estimate HIV incidence among women residing in communities with elevated HIV prevalence who reported personal or partner characteristics associated with increased risk of HIV acquisition
Summary
Ending the epidemic necessitates addressing barriers that impede engagement in biomedical and behavioral prevention and wide scale implementation and utilization of existing interventions This qualitative study identifies suggestions for increasing access to, engagement in, and impact of HIV prevention among women living in cities in high HIV burden counties in the eastern US. As indicated in the national Ending the Epidemic initiative [3], such accomplishments suggest that the knowledge, tools, and resources needed to end the HIV/AIDS epidemic currently exist Despite these successes, HIV remains a glaring example of health inequity in the US, frequently concentrating in socially disadvantaged groups with epidemic rates only in certain types of communities – communities with high numbers of marginalized individuals (including, but not limited to, non-Hispanic Black, Latinx, low income, gay, and transgender communities) [7,8,9]. Continuing a 30 year trend, Black women account for the majority of women living with HIV/AIDS, making Black women 15 and 5 times more likely to contract HIV than White women and Latinas, respectively [10]
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