Brief Report

PrEP Eligibility Among At-Risk Women in the Southern United States: Associated Factors, Awareness, and Acceptability

Anar S. Patel, Lakshmi Goparaju, Jessica M. Sales, Cyra Christina Mehta, Oni J. Blackstock, Dominika Seidman, Igho Ofotokun, Mirjam Colette Kempf, Margaret A. Fischl, Elizabeth Golub, Adaora A. Adimora, Audrey L. French, Jack DeHovitz, Gina Wingood, Seble Kassaye, Anandi N. Sheth

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)527-532
Number of pages6
JournalJournal of acquired immune deficiency syndromes (1999)
Volume80
Issue number5
DOIs
StatePublished - Apr 15 2019

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HIV
Pre-Exposure Prophylaxis
Odds Ratio
Sex Offenses
Confidence Intervals
Centers for Disease Control and Prevention (U.S.)
Education
Self Concept
HIV Infections

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Brief Report : PrEP Eligibility Among At-Risk Women in the Southern United States: Associated Factors, Awareness, and Acceptability. / Patel, Anar S.; Goparaju, Lakshmi; Sales, Jessica M.; Mehta, Cyra Christina; Blackstock, Oni J.; Seidman, Dominika; Ofotokun, Igho; Kempf, Mirjam Colette; Fischl, Margaret A.; Golub, Elizabeth; Adimora, Adaora A.; French, Audrey L.; DeHovitz, Jack; Wingood, Gina; Kassaye, Seble; Sheth, Anandi N.

In: Journal of acquired immune deficiency syndromes (1999), Vol. 80, No. 5, 15.04.2019, p. 527-532.

Research output: Contribution to journalArticle

Patel, AS, Goparaju, L, Sales, JM, Mehta, CC, Blackstock, OJ, Seidman, D, Ofotokun, I, Kempf, MC, Fischl, MA, Golub, E, Adimora, AA, French, AL, DeHovitz, J, Wingood, G, Kassaye, S & Sheth, AN 2019, 'Brief Report: PrEP Eligibility Among At-Risk Women in the Southern United States: Associated Factors, Awareness, and Acceptability', Journal of acquired immune deficiency syndromes (1999), vol. 80, no. 5, pp. 527-532. https://doi.org/10.1097/QAI.0000000000001950
Patel, Anar S. ; Goparaju, Lakshmi ; Sales, Jessica M. ; Mehta, Cyra Christina ; Blackstock, Oni J. ; Seidman, Dominika ; Ofotokun, Igho ; Kempf, Mirjam Colette ; Fischl, Margaret A. ; Golub, Elizabeth ; Adimora, Adaora A. ; French, Audrey L. ; DeHovitz, Jack ; Wingood, Gina ; Kassaye, Seble ; Sheth, Anandi N. / Brief Report : PrEP Eligibility Among At-Risk Women in the Southern United States: Associated Factors, Awareness, and Acceptability. In: Journal of acquired immune deficiency syndromes (1999). 2019 ; Vol. 80, No. 5. pp. 527-532.
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abstract = "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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T2 - PrEP Eligibility Among At-Risk Women in the Southern United States: Associated Factors, Awareness, and Acceptability

AU - Patel, Anar S.

AU - Goparaju, Lakshmi

AU - Sales, Jessica M.

AU - Mehta, Cyra Christina

AU - Blackstock, Oni J.

AU - Seidman, Dominika

AU - Ofotokun, Igho

AU - Kempf, Mirjam Colette

AU - Fischl, Margaret A.

AU - Golub, Elizabeth

AU - Adimora, Adaora A.

AU - French, Audrey L.

AU - DeHovitz, Jack

AU - Wingood, Gina

AU - Kassaye, Seble

AU - Sheth, Anandi N.

PY - 2019/4/15

Y1 - 2019/4/15

N2 - 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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