Considerations for the Design of Pre-exposure Prophylaxis (PrEP) Interventions for Women: Lessons Learned from the Implementation of a Novel PrEP Intervention

AIDS Behav. 2021 Dec;25(12):3987-3999. doi: 10.1007/s10461-021-03353-2. Epub 2021 Jun 17.

Abstract

Pre-exposure prophylaxis (PrEP) uptake among women in the United States has been low. To increase uptake, we developed a peer outreach and navigation PrEP intervention. Semi-structured qualitative interviews with 32 cisgender women and 3 transgender women were conducted to assess the intervention. We used a thematic approach to identify barriers to, and facilitators of the intervention. Facilitators included interest in PrEP, offer of health and social services, the intervention's women-focused approach, and peer outreach and navigation. Barriers were perceived HIV risk, concerns about medication side effects or interactions, housing insecurity and travel, co-occurring health-related conditions, and caregiving responsibilities. We recommend that future interventions consider packaging PrEP in local community settings, such as syringe exchange programs; include services such as food and housing assistance; use peers to recruit and educate women; integrate a culturally appropriate women's focus; and consider providing same-day PrEP.

Keywords: Cisgender women; Drug use; Exchange sex; HIV; Pre-exposure prophylaxis; Syringe service program; Transgender women.

MeSH terms

  • Anti-HIV Agents* / therapeutic use
  • Female
  • HIV Infections* / drug therapy
  • HIV Infections* / prevention & control
  • Humans
  • Needle-Exchange Programs
  • Pre-Exposure Prophylaxis*
  • Transgender Persons*
  • Transsexualism*
  • Vereinigte Staaten

Substances

  • Anti-HIV Agents