Abstract
BackgroundPrior to implementing a pre-exposure prophylaxis (PrEP) demonstration study, we sought to explore cisgender women’s experiences with HIV prevention, PrEP knowledge and attitudes, and anticipated barriers and facilitators for PrEP uptake and adherence in Southern California.MethodsThree focus groups were held with cisgender women of mixed HIV serostatus in San Diego and Los Angeles between November 2015 and January 2016. Women were recruited through local testing sites, community-based organizations, and social media. Focus groups were audio-recorded and transcripts were analyzed using thematic analysis.ResultsTwenty-two women participated in focus groups, with median age 44 (IQR 30–53) and 6 identifying as non-Hispanic Black, 7 non-Hispanic White, 8 Latina and 1 mixed race. Despite limited prior PrEP knowledge and no PrEP experience, participants expressed interest in taking PrEP. Anticipated benefits were freedom from worry about HIV and control over sexual health; however, these were tempered by concerns including the possibility of increased HIV risk behaviors and potential side effects. Cisgender women reported potential barriers to PrEP uptake and adherence barriers, like competing priorities and poor PrEP access. Conversely, PrEP facilitators included utilizing practical tools such as phone apps and pill boxes as well as receiving encouragement from loved ones and support from other cisgender women on PrEP, women living with HIV and their medical providers.ConclusionsAlthough PrEP awareness was low, participants recognized the importance of PrEP and ways to facilitate adherence. Exploring perspectives of cisgender women is integral to developing effective interventions to support PrEP uptake and adherence for women at elevated risk for HIV.
Highlights
Prior to implementing a pre-exposure prophylaxis (PrEP) demonstration study, we sought to explore cisgender women’s experiences with HIV prevention, PrEP knowledge and attitudes, and anticipated barriers and facilitators for PrEP uptake and adherence in Southern California
The decision to conduct focus groups was based on the desire to explore experiences in a group context, allowing for ideas to be considered from multiple perspectives and inviting the possibility for new direction or insights to emerge through group discussions
Participants were a median age of 44 years old (Interquartile Ratio 30–53)
Summary
Prior to implementing a pre-exposure prophylaxis (PrEP) demonstration study, we sought to explore cisgender women’s experiences with HIV prevention, PrEP knowledge and attitudes, and anticipated barriers and facilitators for PrEP uptake and adherence in Southern California. Since its approval in 2012, PrEP use Unlike men who have sex with men (MSM) and transgender women (TGW), risk factors for cisgender. Living in high HIV prevalence areas, having a history of sexually transmitted infections (STIs), participating in transactional sex, experiencing intimate partner violence, and engaging in injection drug use (IDU) may all contribute to a woman’s lifetime risk for HIV acquisition [6]. Improved and multi-faceted HIV prevention efforts, that include PrEP use, are needed to address HIV acquisition among cisgender women. Cisgender women have been found to have lower awareness of PrEP than MSM [8].
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