Faculty, Staff and Student Publications
Publication Date
1-1-2025
Journal
AIDS and Behavior
Abstract
Pre-exposure prophylaxis (PrEP) can significantly reduce human immunodeficiency virus (HIV) transmission among Black women in the United States (U.S.), a group disproportionately affected by HIV. However, PrEP uptake in this HIV-vulnerable population is low. This review analyzes the factors influencing Black women's PrEP willingness using the Behavioral Model for Vulnerable Populations (BMVP). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Population, Intervention, Comparison, Outcome, Study Design (PICOS) framework, we conducted a systematic literature search and selected 24 peer-reviewed studies on PrEP willingness. Narrative synthesis revealed a heterogeneous landscape of the determinants affecting PrEP willingness among Black women, categorized into three main domains. Predisposing demographic and social factors included younger age, unmarried status, higher education, sexual or gender minority identity, trust in healthcare providers, and perceived HIV risk. Predisposing behavioral factors included condomless sex, multiple partners, and engagement in sex work. Socioeconomic status, health insurance, healthcare access, support systems, and structural challenges were identified as enabling factors influencing Black women's PrEP willingness. Finally, the perceived need domain and health-related factors influencing the perceived need for PrEP included a history of sexually transmitted infections (STI), intimate partner violence (IPV), and birth control interference. This study emphasizes the complexity of the barriers and facilitators of PrEP uptake and, thus, the need for tailored interventions and health strategies to promote its use. Addressing the interconnected individual, interpersonal, and structural determinants of PrEP access is crucial for improving PrEP willingness and thereby advancing health equity in this population.
Keywords
Humans, HIV Infections, Female, Pre-Exposure Prophylaxis, Black or African American, Patient Acceptance of Health Care, Anti-HIV Agents, Health Knowledge, Attitudes, Practice, United States, Sexual Partners, Sexual Behavior, Vulnerable Populations, Adult, White, PrEP, Systematic review, HIV/AIDS, HIV prevention, Black women, PRISMA
DOI
10.1007/s10461-024-04491-z
PMID
39340583
PMCID
PMC11739211
PubMedCentral® Posted Date
9-28-2024
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Included in
Behavioral Medicine Commons, Community Health and Preventive Medicine Commons, Public Health Education and Promotion Commons, Women's Health Commons