Predictors of HIV-related risk perception and PrEP acceptability among young adult female family planning patients

ABSTRACT

HIV pre-exposure prophylaxis (PrEP) presents new opportunities for HIV prevention. While women comprise approximately 20% of new HIV infections in the US, significant questions remain about how to most effectively facilitate PrEP uptake for this population. Family planning clinics are a dominant source of health care for young women and support an estimated 4.5 million women annually. We explore characteristics associated with HIV risk perception and PrEP acceptability among young adult women seeking reproductive health services in a high-prevalence setting. A cross-sectional, clinic-based survey was conducted with women ages 18–35 (n = 146) seeking health care at two family planning clinics in the greater Baltimore, Maryland area, from January to April 2014. An estimated 22% of women reported being worried about HIV risk, and 60% reported they would consider taking a pill daily to prevent HIV. In adjusted models, HIV-related worry was associated with having no college education, being single or dating more than one person, practicing consistent condom use during vaginal sex, and having ever traded sex. PrEP acceptability was significantly associated with being Black (71% vs. 49%, AOR 2.23, CI: 1.89–2.64) and having ever traded sex (83% vs. 58%, AOR 4.94, CI: 2.00–12.22). For women with a history of intimate partner violence (IPV), PrEP acceptability was significantly lower (57% vs. 62%, AOR .71, CI: .59–.85) relative to their non-abused counterparts. Results suggest that family planning clinics may be a natural setting for PrEP discussion and roll-out. They should be considered in the context of integrating HIV prevention with reproductive health services. Women with a trauma history may need additional support for implementing HIV prevention in the form of PrEP.

KEYWORDS:

• HIV prevention
• risk
• PrEP
• sex work
• violence

Acknowledgments

The information, content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by NIH, OWH, DHSS, or the U.S. government.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was conducted with funding from the U.S. Department of Health and Human Services, Office on Women’s Health (OWH; ASTWH090016-01-00; Project Connect: Public Health Partnerships to Respond to Domestic Violence, Sexual Violence and Reproductive Coercion). The authors additionally disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: the Johns Hopkins University Center for AIDS Research (P30AI094189); T32-HDO64428, and T32MH020031; National Institute of Child Health and Human Development; National Institute of Mental Health; Office of AIDS Research.