A Qualitative Study of Barriers and Facilitators of PrEP Uptake Among Women in Substance Use Treatment and Syringe Service Programs

Susan Tross, Anya Y. Spector, Melissa M. Ertl, Hayley Berg, Eva Turrigiano, Susie Hoffman

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

PrEP is an HIV prevention option that could benefit substance-involved women, a high-risk population with low PrEP uptake. Little is known about their interest in PrEP. This qualitative study used in-depth interviews to examine PrEP willingness, barriers, and facilitators among 16 women in outpatient psychosocial substance use treatment, methadone, and/or harm reduction/syringe programs in NYC. All expressed willingness to use PrEP, but only during periods of perceived risk. Women perceived themselves to be at high risk for HIV when engaging in active substance use and/or transactional sex. They perceived themselves to be at low risk and therefore unmotivated to take PrEP when abstinent from these activities. Paradoxically, a major barrier to using PrEP was anticipated interference from substance use and transactional sex, the very same activities that create a perception of risk. Facilitators of PrEP use included perceptions of it as effortless (as opposed to barrier methods during sex) and effective, safe, and accessible. Other barriers included fear of stigma and doubts about adhering daily. Recommendations for best PrEP implementation practices for substance-involved women included tailored and venue-specific PrEP information and messaging, PrEP discussion with trusted medical providers, and on-site PrEP prescription in substance use treatment and harm reduction programs.

Original languageEnglish (US)
Pages (from-to)1162-1172
Number of pages11
JournalAIDS and Behavior
Volume27
Issue number4
DOIs
StatePublished - Apr 2023
Externally publishedYes

Bibliographical note

Funding Information:
This work was supported by a National Institute of Mental Health Center Grant (P30-MH43520; Remien, PI). Dr. Ertl was also supported by a National Institute of Mental Health Training Grant (T32-MH19139; Sandfort, PI) as well as a training grant funded by the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism (R25DA050687-01A1; Valdez, PI). The content is solely the responsibility of the authors and does not necessarily represent the official views of National Institute of Mental Health or the National Institutes of Health.

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Keywords

  • HIV prevention
  • implementation
  • Pre-exposure prophylaxis (PrEP)
  • women

PubMed: MeSH publication types

  • Journal Article

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