3:00pm - 4:00pm (CDT) | 2114.0 - Identifying barriers and challenges to PrEP uptake among cisgender and transgender black women

Session: HIV: Eliminating Related Disparities

Program: HIV/AIDS

Presenter: Anna Pelc, MS, MBA, MPH

Author: Christine Simon, ScM, ScD

Abstract

Background

In the United States, an estimated 16.4 per 100,000 Black women are diagnosed with HIV compared to 1.5 per 100,000 White women. Similarly, in Connecticut, the rates of HIV diagnoses were disproportionately higher among Black women, 13.2 per 100,000, compared to 1.4 per 100,000 in White women. Pre-Exposure Prophylaxis (PrEP) has been found to reduce the risk of contracting HIV from sex by over 90%, if taken as prescribed. However, on average, only 2% of eligible cisgender and 3% of high-risk transgender Black women report taking PrEP. Black women, both cisgender and transgender, face unique barriers to initiating PrEP, and this study will identify these barriers and provide strategies for increasing PrEP acceptance.

Methods

Semi-structured interviews were conducted between March and June 2024 with a purposive and convenience sample of adult cisgender and transgender Black women living in Connecticut. Participants were recruited through local community organizations. The interview guide included questions gauging awareness, knowledge, and perceptions of PrEP and explored individual and systemic barriers and challenges to taking PrEP. Rapid qualitative analysis was used to summarize transcript data into templates using domains based on the interview guide. Summaries will be reviewed with community stakeholders to aid in data interpretation.

Results

Preliminary results identify barriers to PrEP use such as lack of awareness, misperceptions about PrEP, and concerns around access to PrEP that are specific to Connecticut. Interpersonal challenges related to discomfort discussing PrEP and mistrust were also described. Additional barriers discussed, such as social stigma, concerns about PrEP side effects and taking a daily pill, align with the barriers reported more broadly. Innovative strategies for promoting PrEP uptake, including recommendations for health education and outreach and improvements to clinical and community-based PrEP care and services, will be identified and discussed.

Conclusions

Preliminary findings suggest that improving access to PrEP and providing tailored counseling and clinical education may help to increase PrEP uptake and adherence by cisgender and transgender Black women. Findings from this study will be used to inform and improve HIV prevention strategies and programs in Connecticut.