Women Trust Their OBGYNs to Provide Preexposure Prophylaxis: An Opportunity for HIV Prevention.
Antoinette A Danvers, Emma Chew Murphy, Karina Avila, Tatiana Gonzalez-Argoti, Angelic Rivera Edwards, Susie Hoffman, Joanne E Mantell, Laurie J Bauman, Siobhan M Dolan
Author Information
Antoinette A Danvers: Department of Obstetrics and Gynecology and Women's Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, United States.
Emma Chew Murphy: Department of Obstetrics and Gynecology and Women's Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, United States.
Karina Avila: Department of Obstetrics and Gynecology and Women's Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, United States.
Tatiana Gonzalez-Argoti: Departments of Pediatrics and Psychiatry and Behavioral Health, Albert Einstein College of Medicine, Bronx, NY, United States.
Angelic Rivera Edwards: Montefiore School Health Program, Department of Pediatrics, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, United States.
Susie Hoffman: Department of Epidemiology, Joseph L. Mailman School of Public Health at Columbia University, New York, NY, United States.
Joanne E Mantell: Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, United States.
Laurie J Bauman: Departments of Pediatrics and Psychiatry and Behavioral Health, Albert Einstein College of Medicine, Bronx, NY, United States.
Siobhan M Dolan: Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai and Mount Sinai Health System, New York, NY, United States.
Objective: The objective of this study was to understand how women perceive the role of their Obstetrician and Gynecologist (OBGYN) in screening for and providing preexposure prophylaxis (PrEP) for HIV prevention. Methods: We recruited women ages 18-45 years receiving obstetric or gynecological care at an academic medical center in the Bronx, NY. Thirty Participants were enrolled: 10 seeking care for family planning, 10 seeking prenatal care, and 10 seeking care for a sexually transmitted infection. We screened Participants for HIV acquisition risk using a PrEP screening tool. We conducted face-to-face, semi-structured interviews, which were audio-recorded, transcribed, and entered into Dedoose for analysis of themes using a grounded theory approach. Results: Sixty percent of the Participants were Latinx and 33% African American. Seventy percent had one or more risk factors for HIV acquisition based on the PrEP screening tool, indicating they would benefit from a PrEP discussion. Three main themes emerged from the analysis of interview data. Participants viewed OBGYNs as experts in sexual and reproductive healthcare and believed they were experts in PrEP. Participants were concerned about "PrEP stigma", being judged by their clinicians as being sexually promiscuous if they expressed a need for PrEP. Lastly, when Participants trusted their OBGYN, that trust became a facilitator for women to consider PrEP and offset stigma as a barrier to identifying patients who are candidates for PrEP. Conclusion: women established in care with an OBGYN are enthusiastic about having access to PrEP services incorporated into their sexual and reproductive healthcare. A universal approach to HIV prevention would avert stigma surrounding HIV care and prevention.
