“…If the Doctor Didn't Suggest it, Then I Would Probably Push the Idea Farther in My Head.”: Centering the Diverse Voices of Black Women to Understand PrEP Awareness and Access in the United States South

Abstract

CONTEXT: In Atlanta, Georgia Black women account for most of new HIV diagnoses among women and 30% of Black women may benefit from pre-exposure prophylaxis (PrEP). Yet their PrEP knowledge, awareness, and access are low. METHODS: This study centers the voices of an economically diverse sample of 22 Black women-annual incomes from $0 to greater than $150,000-to explore their perspectives about PrEP. After consenting, women engaged in focus groups (n = 6). Rapid qualitative analysis was used to identify themes. RESULTS: Participants indicated that there was low percieved appropriateness of PrEP among Black women; expressed that Black women desired PrEP; emphasized the importance of providers' recommendations in PrEP decision-making; and identified stigma, racial bias, cost, and side effects as PrEP access and initiation barriers. Most women indicated a preference for injectable PrEP. CONCLUSION: Marketing that appeals to Black women; efforts that address the cost of PrEP; and PrEP education for clinicians may increase PrEP awareness, access, and uptake among Black women.