PrEP Awareness and Use among Reproductive Age Women in Miami, Florida Open Access
Fonseca Nogueira, Nicholas (Summer 2022)
Published
Abstract
Introduction: Miami, Florida is the epicenter of the HIV epidemic in the US, with 20% of new HIV infections occurring in women. Despite the effectiveness of Pre-Exposure Prophylaxis (PrEP) in preventing HIV, only 10% of eligible women benefit from its use. This study evaluates PrEP awareness and use, and factors associated with PrEP awareness among sexually active women in Miami-Dade County, Florida.
Methods: From 2018 to 2022, cis-gender, HIV-negative, 18-45-year-old, sexually active women were recruited as part of a study evaluating recurrent bacterial vaginosis and HIV risk. Participants completed a questionnaire assessing: socio-demographics, HIV risk factors, history of HIV testing and reproductive tract infections, PrEP awareness and PrEP use. Factors associated with PrEP awareness were analyzed by Chi-square, Fisher’s exact test, or studentized t-test. Multivariable logistic regression (MLR) was performed to identify factors associated with PrEP awareness.
Results: Overall, 295 women were enrolled (median age 31 (24-38) years). The sample was 49% Black, 39% White, and 34% Hispanic. Eighty percent were heterosexual, 24% had consistent condom use, and the mean number of male partners in the previous month was 1.6 (±2.57). Of the 63% who knew about PrEP, only 5% were on PrEP. Women with income below poverty line (OR=2.00 [1.04,3.87]; p=0.04), more male sexual partners (OR=1.30 [1.01,1.68]; p=0.04), prior HIV testing (OR=6.42 [2.83,14.52]; p<0.01), or a current diagnosis of bacterial vaginosis (OR=2.28 [1.18,4.40]; p=0.01) were more likely to be aware of PrEP. Lower odds of PrEP awareness were associated with being Black (OR=0.38 [0.15,0.96]; p=0.04), Hispanic (OR=0.18 [0.08,0.39]; p<0.01), Heterosexual (OR=0.29 [0.11,0.77]; p<0.01), and reporting inconsistent condom use during vaginal sex (OR=0.21 [0.08,0.56]; p<0.01).
Conclusion: Despite high risk for HIV acquisition, PrEP awareness is low among reproductive age women in a high-risk setting. Culturally tailored interventions are needed to increase PrEP awareness and uptake, especially among for Black and Hispanic women who have inconsistent condom use during vaginal sex.
Table of Contents
Literature Review ……………………………………………………………………....……….…1
Problem and Purpose …………………………………………………………...…………1
HIV and Southern United States …………………………………………….………….1
HIV Transmission and Risk Factors ………………………………………….…………2
PrEP Success in HIV Prevention among Women………………………….………….4
Predictors of PrEP Awareness and Use …………………………………………………6
Manuscript ……………………………………………………………………………….....………7
Introduction ……………………………………………………………………....………...7
Methods ………………………………………………………………………….......………9
Results ………………………………………………………………………….......……….11
Discussion …………………………………………………………………......……………12
Acknowledgements …………………………………………………………....………….14
Expanded Discussion ………………………………………………………………..……………15
References ……………………………………………………………………………....………….19
List of Tables and Figures
Table 1. Sociodemographic, history of pregnancy and HIV testing, and contraceptive
use by PrEP Awareness Status (n = 295)……….………………………………...….………...25
Table 2. PrEP Use, Risk Behaviors, BV, and STI by PrEP Awareness Status (n = 295)...27
Appendix. Table 3. Multivariable logistic regression assessing predictors of PrEP
Awareness (n = 247) ………………………………………..………………………………………29
Figure 1. Adjusted Odds Ratios for PrEP Awareness, by Predictors ……………………...31
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