Adapting Provider Training and Pre-Exposure Prophylaxis Advertising to Increase Pre-Exposure Prophylaxis Awareness and Uptake Among Black Cisgender Women.
Samantha A Devlin, Jessica P Ridgway, Alicia Dawdani, Ososese E Enaholo, Geoffroy Liegeon, Nikki Kasal, Maria Pyra, Lisa R Hirschhorn, Jodi Simon, Sadia Haider, Kelly Ducheny, Amy K Johnson
Author Information
Samantha A Devlin: Department of Medicine, University of Chicago, Chicago, Illinois, USA. ORCID
Jessica P Ridgway: Department of Medicine, University of Chicago, Chicago, Illinois, USA. ORCID
Alicia Dawdani: Department of Medicine, University of Chicago, Chicago, Illinois, USA.
Ososese E Enaholo: The Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
Geoffroy Liegeon: Department of Medicine, University of Chicago, Chicago, Illinois, USA.
Nikki Kasal: Department of Medicine, University of Chicago, Chicago, Illinois, USA.
Maria Pyra: Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Lisa R Hirschhorn: Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Jodi Simon: AllianceChicago, Chicago, Illinois, USA.
Sadia Haider: Division of Family Planning, Rush University, Chicago, Illinois, USA.
Kelly Ducheny: Howard Brown Health, Chicago, Illinois, USA.
Amy K Johnson: The Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
Black cisgender women (hereafter referred to as "women") have disproportionately high rates of HIV infection yet low rates of pre-exposure prophylaxis (PrEP) utilization. Barriers to PrEP uptake exist at the system, provider, and individual/client level. To learn how existing training and advertising can be adapted to address race- and sex-based gaps within PrEP service delivery, we conducted focus groups with providers and Black women. Participants were recruited at three health care organizations in the Midwest and South, screened for eligibility, and consented verbally. Focus groups occurred from August 2022 to February 2023. Women were asked about their knowledge and thoughts on PrEP. Providers were asked about factors influencing their decision-making about PrEP. A codebook was developed based on the Consolidated Framework for Implementation Research. Transcripts were coded using the Stanford Lightning Report Method. We completed four focus groups with 10 providers and 9 focus groups with 25 women. Three major themes emerged: (1) low comfort level and limited cultural sensitivity/competency among providers discussing HIV risk and PrEP with Black women, (2) women's concerns about PrEP's side effects and safety during pregnancy, and (3) lack of Black women representation in PrEP advertisement/educational materials. In addition, women in the South reported general medical mistrust and specific misconceptions about PrEP. PrEP trainings for providers need detailed information about the safety of PrEP for women and should include role-playing to enhance cultural competency. Likewise, PrEP advertisements/materials should incorporate information regarding side effects and images/experiences of Black women to increase PrEP awareness and uptake among this population. Clinical Trial Registration Number: NCT05626452.
