3265.0 Developing a trauma-informed HIV pre-exposure prophylaxis (PrEP) implementation toolkit to increase initiation among black cisgender women

Session: Advancing the PrEP Continuum

Program: HIV/AIDS

Time: 2:45 - 3:00 PM

Presenters:

Trace Kershaw, PhD

Abstract

Background: Intimate partner violence (IPV) and HIV represent mutually-reinforcing epidemics disproportionately affecting U.S. Black cisgender women. IPV can increase HIV acquisition risk through multiple behavioral and physiological pathways including forced sex and stress dysregulation. HIV pre-exposure prophylaxis (PrEP) is a promising partner-independent prevention strategy with suboptimal coverage among Black women. This study aimed to identify key components of trauma-informed PrEP implementation from the perspectives of Black women and clinical staff.

Methods: Focus groups with 37 PrEP-eligible Black cisgender women (February-June 2019), and semi-structured interviews with 7 clinical staff offering HIV prevention services (October-November 2020) in Mississippi were conducted. Focus group discussions and interviews were conducted and coded by Black cisgender women from the U.S. South. Interview and FDG data was analyzed using both inductive and deductive approaches.

Results: Seven themes were identified as needed to facilitate integration of trauma-informed approaches into existing PrEP programs, including defining IPV, appropriate IPV screening and response, HIV prevention in abusive relationships, staff training needs, and creating supportive clinic environments. PrEP-eligible Black women and clinical staff generally agreed on how to best operationalize IPV screening and response, the importance of trauma-informed staff training, and the need for Black women-specific informational campaigns. However, Black women highlighted the need for providers to discuss HIV prevention in controlling relationships, and to respond to IPV disclosure.

Conclusions: Integrating trauma-informed principles with PrEP implementation might increase access among Black women by creating safe environments to discuss IPV and safety plan to enhance PrEP access.