Abstract
ObjectiveThe objective of this study was to understand how women perceive the role of their Obstetrician and Gynecologist (OBGYN) in screening for and providing preexposure prophylaxis (PrEP) for HIV prevention.MethodsWe recruited women ages 18–45 years receiving obstetric or gynecological care at an academic medical center in the Bronx, NY. Thirty participants were enrolled: 10 seeking care for family planning, 10 seeking prenatal care, and 10 seeking care for a sexually transmitted infection. We screened participants for HIV acquisition risk using a PrEP screening tool. We conducted face-to-face, semi-structured interviews, which were audio-recorded, transcribed, and entered into Dedoose for analysis of themes using a grounded theory approach.ResultsSixty percent of the participants were Latinx and 33% African American. Seventy percent had one or more risk factors for HIV acquisition based on the PrEP screening tool, indicating they would benefit from a PrEP discussion. Three main themes emerged from the analysis of interview data. Participants viewed OBGYNs as experts in sexual and reproductive healthcare and believed they were experts in PrEP. Participants were concerned about “PrEP stigma”, being judged by their clinicians as being sexually promiscuous if they expressed a need for PrEP. Lastly, when participants trusted their OBGYN, that trust became a facilitator for women to consider PrEP and offset stigma as a barrier to identifying patients who are candidates for PrEP.ConclusionWomen established in care with an OBGYN are enthusiastic about having access to PrEP services incorporated into their sexual and reproductive healthcare. A universal approach to HIV prevention would avert stigma surrounding HIV care and prevention.
Highlights
According to the United States (U.S.) Centers for Disease Control and Prevention’s 2018 HIV Surveillance Report, about 20% of new HIV infections in the U.S occur in women
This study aimed to identify attitudes of women of color toward PrEP and to understand their receptivity to PrEP education and initiation from their OBGYN
As part of a study aimed at identifying barriers to PREP uptake among women of color, we recruited participants from an ambulatory OBGYN clinic at Montefiore Medical Center, an academic medical center in the Bronx, NY
Summary
According to the United States (U.S.) Centers for Disease Control and Prevention’s 2018 HIV Surveillance Report, about 20% of new HIV infections in the U.S occur in women. The report reveals significant racial disparities in the incidence of new HIV infections, with African American women accounting for almost 60% of new HIV infections among women. This means that African American women have a 1 in 54 lifetime risk of receiving an HIV diagnosis [1]. The persistently high rates of HIV among African Americans and Latinxs are a major concern. Preexposure prophylaxis (tenofovir plus emtricitabine, PrEP) significantly decreases the risk of HIV transmission [2], making it a critical opportunity for women at risk. Increasing the uptake of PrEP among women, especially African Americans and Latinxs, is an essential strategy for decreasing the rate of new HIV infections in the US [5]. Efforts in the U.S to increase the uptake of PrEP have primarily targeted men who have sex with men (MSM), and uptake and knowledge by at-risk women remains low [5]
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