Perceptions of Factors that Influence the Potential Use of Pre-Exposure Prophylaxis (PrEP)

Background: In the United States, African American women are twenty times more likely than white counterparts to contact Human Immunodeficiency Virus (HIV). Pre-Exposure Prophylaxis (PrEP) is a medication proven to reduce the likelihood of acquiring HIV in high-risk populations. Despite the high HIV infection rate, there is little known about factors that might influence the likelihood of using PrEP in African American. Purpose: This dissertation had two aims (1) to describe the HIV sexual risk behaviors, use of media as a potential source of PrEP information, HIV testing intentions, and current levels of PrEP awareness of high-risk African American women in order to determine the most effective ways of informing them about PrEP, (2) to determine which factors influence African American women’s likelihood of using PrEP for HIV prevention and (3) to compare African American women’s perceptions of factors influencing PrEP use to perceptions of healthcare providers. Methods: This Chicago based study has enrolled 48 African American women, ages 18-49, at high-risk for acquiring HIV and 10 healthcare providers. The inductive, qualitative approach of concept mapping in conjunction with quantitative analysis using Concept System Software was used. The questionnaire collected information on current media use, HIV testing history, sexual risk behaviors, and demographics. To ensure basic understanding of PrEP, participants received education about PrEP by watching a five-minute animated video from whatisprep.com. Trochim’s concept mapping process has six steps: preparation, generation of statements (brainstorming), structuring of statements (sorting & rating), representation of statements (analysis), focus group discussion (interpretation of maps), and utilization of maps. Data was entered into Concept System Software (CS Global Max). Results: African American women who engage in high-risk behaviors perceive themselves to be at low risk for HIV acquisition. African American women are not being informed about PrEP during visits for HIV tests or routine healthcare visits. Television, radio, and Facebook may be ideal modes for disseminating PrEP information, as these media were used frequently by participants in an average month. African American women have little awareness of PrEP, and the study participants did not know other women who had used PrEP. In terms of concept mapping, 8 clusters were identified as factors likely to influence the use of PrEP and “Knowing that PrEP will prevent me from getting HIV when my partner won’t use a condom” was the most likely to influence potential use of PrEP among African American women, whereas healthcare providers perceived “Having an HIV positive partner” to be the most influential statement.