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BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2021

01-12-2021 | Human Immunodeficiency Virus | Research article

“PrEP’s just to secure you like insurance”: a qualitative study on HIV pre-exposure prophylaxis (PrEP) adherence and retention among black cisgender women in Mississippi

Authors: Tiara C. Willie, Mauda Monger, Amy Nunn, Trace Kershaw, Jamila K. Stockman, Kenneth H. Mayer, Philip A. Chan, Adaora A. Adimora, Leandro A. Mena, Deja Knight, Karlye A. Philllips, Stefan D. Baral

Published in: BMC Infectious Diseases | Issue 1/2021

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Abstract

Background

Pre-exposure prophylaxis (PrEP) has the potential to reduce transmission of HIV among Black cisgender women in the Southern United States (U.S.); however, national data suggests that PrEP initiation is lowest in the South and among Black women compared to other U.S. regions and white women. This study applied intersectionality and PrEP multilevel resilience frameworks to assess how socio-structural and clinical contexts shaped PrEP persistence among Black cisgender women in Mississippi.

Methods

Semi-structured interviews were conducted with eight Black cisgender women in Jackson, Mississippi. This sample was purposively recruited to include PrEP-initiated Black cisgender women.

Results

Six themes identified that shaped PrEP care among Black cisgender women: (1) internal assets, (2) sole responsibility to HIV prevention, (3) added protection in HIV serodifferent relationships, (4) financial issues, (5) trust and distrust in the medical system, and (6) side effects. Black cisgender women reported that PrEP persistence increased control over their sexual health, reduced anxiety about HIV, and promoted self-care. Black cisgender women also indicated that medication assistance programs increased PrEP affordability resulting in continued persistence.

Conclusions

In addition to preventing HIV, PrEP may yield secondary positive impacts on the health and relationships of Black cisgender women. However, very few Black cisgender women in the South are using PrEP given intersectional barriers and thus necessitates adaptive strategies to support PrEP initiation and persistence. Efforts aimed at increasing the coverage of PrEP among Black cisgender women should consider implementation strategies responsive to lived realities of Black women.
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Metadata
Title
“PrEP’s just to secure you like insurance”: a qualitative study on HIV pre-exposure prophylaxis (PrEP) adherence and retention among black cisgender women in Mississippi
Authors
Tiara C. Willie
Mauda Monger
Amy Nunn
Trace Kershaw
Jamila K. Stockman
Kenneth H. Mayer
Philip A. Chan
Adaora A. Adimora
Leandro A. Mena
Deja Knight
Karlye A. Philllips
Stefan D. Baral
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2021
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-021-06786-1

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