Associate Professor UTHealth Houston McGovern Medical School
Abstract Title
Women’s perspectives on HIV prevention: A qualitative study examining barriers and facilitators to PrEP care for women with problematic substance use
Abstract Authors
Angela Heads Adrienne Gilmore Thomas Miana Graves Kaixuan An Mandy Hill Joy Schmitz
Author Affiliations
University of Texas Health Science Center Houston, McGovern Medical School Houston, TX USA
Background
Although new HIV diagnoses have declined each year since 2010, there have been no significant declines in the number of new annual HIV diagnoses among women since 2013. This is an indication that effective prevention strategies are not reaching all audiences. People with problematic substance use have increased susceptibility to HIV due to injection drug use, sex in exchange for money or drugs, and condomless sex while under the influence of alcohol and drugs. Women-focused Interventions are needed to decrease new HIV diagnoses within this population.
Methods
Trained doctoral-level interviewers conducted 25 in-depth semi-structured interviews with women in treatment for substance use disorders between June 2022 and March 2023. An interview guide based on IMB principles was used to illicit information on knowledge of and motivation to use HIV prevention methods including PrEP, perceptions of risk, preferred sources of health information, and feasibility of integrating PrEP care into addiction treatment settings. Data were coded and analyzed using MAXQDA 2022.
Results
Twenty-five interviews were conducted with women ages 26 to 70 (Mage=42 (11.03). The sample was racially/ethnically diverse (44%-Black, 44%-White, 12%-More than one Race, 24% Hispanic/Latinx. Participants reported limited knowledge and awareness of PrEP. Reasons for not being regularly tested for HIV or using PrEP included low perceived risk for HIV or not being offered these prevention tools by their health care providers. Women reported perceptions that PrEP was meant for others (e.g. men who have sex with men). They pointed to the implied target audience in advertisements as evidence for this belief and suggested making information about HIV prevention (including PrEP) more widely available starting at a younger age. Respondents were open to integrating HIV prevention and PrEP care into addiction treatment settings but expressed concerns about stigma related to both HIV and substance use.
Conclusion(s)
Despite public health efforts, women are still not being provided adequate information on HIV prevention to help them to make informed decisions for their sexual health. HIV prevention advertising campaigns targeted towards women and their providers should be considered. More research is needed to determine effective strategies for integrating HIV prevention into multiple settings.