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

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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.

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Acknowledgements

We are grateful to Tonia Poteat, PhD, PA-C, MPH, and Hilary Surratt, PhD for insightful discussions during the early stages of this project and to Axcel Barboza for his input into planning and implementation phases of this study. The authors would also like to thank colleagues at NDRI for their assistance with Peer training. This project was supported by a Centers for Disease Control and Prevention Minority HIV/AIDS Research Initiative Grant (1U01PS005111-01).

Funding

This work was funded by the Centers for Disease Control and Prevention Minority HIV/AIDS Research Initiative Grant (1U01PS005111-01), PI: Oni J. Blackstock; T32 DA007233-31, PI: Falkin; and R25DA026401, PI Avelardo Valdez.

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Authors and Affiliations

  1. School of Global Public Health, New York University, New York, NY, USA

    Suzan M. Walters

  2. Division of General Internal Medicine, Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY, 10467, USA

    Joey Platt, Amarachi Anakaraonye, Chinazo O. Cunningham, Brianna L. Norton & Oni J. Blackstock

  3. Department of Psychology, Hunter College, City University of New York, New York, NY, USA

    Sarit A. Golub

  4. Department of Medicine, University of California San Francisco, San Francisco, CA, USA

    Jae M. Sevelius

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Walters, S.M., Platt, J., Anakaraonye, A. et al. Considerations for the Design of Pre-exposure Prophylaxis (PrEP) Interventions for Women: Lessons Learned from the Implementation of a Novel PrEP Intervention. AIDS Behav 25, 3987–3999 (2021). https://doi.org/10.1007/s10461-021-03353-2

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