Journal
JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
Volume 80, Issue 5, Pages 527-532Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QAI.0000000000001950
Keywords
HIV prevention; PrEP eligibility; PrEP awareness; PrEP acceptability; women; Southern US
Categories
Funding
- UABMS WIHS [U01-AI-103401]
- Atlanta WIHS [U01-AI-103408]
- Bronx WIHS [U01-AI-035004]
- Chicago WIHS [U01-AI-034993]
- Metropolitan Washington WIHS [U01-AI-034994]
- Miami WIHS [U01-AI-103397]
- UNC WIHS [U01-AI-103390]
- Connie Wofsy Women's HIV Study, Northern California [U01-AI-034989]
- WIHS Data Management and Analysis Center [U01-AI-042590]
- Southern California WIHS [U01-HD-032632]
- National Institute of Allergy and Infectious Diseases (NIAID)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
- National Cancer Institute (NCI)
- National Institute on Drug Abuse (NIDA)
- National Institute on Mental Health (NIMH)
- National Institute of Dental and Craniofacial Research (NIDCR)
- National Institute on Alcohol Abuse and Alcoholism (NIAAA)
- National Institute on Deafness and other Communication Disorders (NIDCD)
- NIH Office of Research on Women's Health
- UCSF CTSA [UL1-TR000004]
- Atlanta CTSA [UL1-TR000454]
- UNC CFAR [P30-AI-050410]
- EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT [K12HD001262] Funding Source: NIH RePORTER
- NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES [TL1TR002382] Funding Source: NIH RePORTER
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [U01HL146241, U01HL146194] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES [U01AI103401, U01AI034994, U01AI103390, U01AI031834, P30AI050409, U01AI103408, U01AI035004, U01AI034989, U01AI103397, U01AI042590, U01AI034993, P30AI050410, K23AI114407] Funding Source: NIH RePORTER
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Background: Among women in the United States, non-Latina black women in the South have disproportionately high rates of new HIV infections but low use of pre-exposure prophylaxis (PrEP). Effective strategies to identify factors associated with PrEP eligibility could facilitate improved screening, offering, and uptake of PrEP among US women at risk of HIV. Setting and methods: We applied 2014 CDC criteria for PrEP use to at-risk HIV-negative women enrolled in the Southern US sites (Atlanta, Chapel Hill, Birmingham/Jackson, Miami) of the Women's Interagency HIV Study from 2014 to 2015 to estimate PrEP eligibility and assess PrEP knowledge and acceptability. Factors associated with PrEP eligibility were assessed using multivariable models. Results: Among 225 women, 72 (32%) were PrEP-eligible; the most common PrEP indicator was condomless sex. The majority of PrEP-eligible women (88%) reported willingness to consider PrEP. Only 24 (11%) PrEP-eligible women had previously heard of PrEP, and only 1 reported previous use. Education level less than high school [adjusted odds ratio (aOR) 2.56; 95% confidence interval (CI): 1.22 to 5.37], history of sexual violence (aOR 4.52; 95% CI: 1.52 to 17.76), and medium to high self-perception of HIV risk (aOR 6.76; 95% CI: 3.26 to 14.05) were significantly associated with PrEP eligibility in adjusted models. Conclusions: Extremely low PrEP awareness and use despite a high proportion of eligibility and acceptability signify a critical need to enhance PrEP education and delivery for women in this region. Supplementing CDC eligibility criteria with questions about history of sexual violence and HIV risk self-assessment may enhance PrEP screening and uptake among US women.
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