A study conducted in Chicago, where there has been a concerted effort to educate women at risk for HIV about Truvada (tenofovir disoproxil fumarate/emtricitabine) as pre-exposure prophylaxis (PrEP), found a disappointingly low level of awareness about the daily HIV prevention pill among this population, aidsmap reports.
Lisa Hirschhorn, MD, MPH, and her colleagues at Northwestern University partnered with the AIDS Foundation of Chicago and the city’s department of health to conduct a survey about PrEP. It included 370 HIV-negative cisgender (not transgender), nonpregnant women who visited either an emergency department (250 women) or a sexually transmitted infection (STI) clinic (120 women). The investigators also recruited a dozen of these women to participate in a focus group about PrEP.
As the investigators described in the Journal of Acquired Immune Deficiency Syndromes, 83% of the women were Black, and 70% had a regular source of health care. Asked about sexual behaviors during the previous six months, 84% reported having vaginal or anal sex, and 94% reported inconsistent condom use.
Thirty percent of the women had heard of PrEP. After being taught about the use of daily Truvada for HIV prevention, one in four considered starting it. The top reasons for waiting to do so included protecting personal health (76%) and reducing worry about HIV acquisition (58%).
After adjusting the data to account for various differences between the women, the study authors found that being Latina, compared with being white, was associated with a 3.3-fold increased likelihood of considering starting PrEP. Having a recent STI, compared with not having one, was associated with a 2.4-fold increased likelihood. Having a higher belief in PrEP’s effectiveness was associated with a 1.85-fold increased likelihood of considering it.
Eighty-one percent of the women expressed concerns about PrEP, with potential side effects emerging as the most common such concern.
The qualitative interviews revealed themes that were in line with the survey results. In particular, the study identified a disconnection between these women’s perspectives and current PrEP marketing, while also illuminating a need for community-level PrEP education and outreach to women. Women’s trust in their health care providers was also an important factor in their interest in and willingness to take PrEP.
“Despite significant PrEP implementation work in Chicago, less than one third of women in our study had heard of PrEP,” the study authors concluded. “Once informed, PrEP attitudes and interest were positive. Translating these results into interventions reflecting women’s preferences and barriers is critical to increase PrEP uptake by cisgender women in Chicago and elsewhere."
To read the study abstract, click here.
To read the aidsmap article, click here.