Affordable Access

deepdyve-link
Publisher Website

Structural and syndemic barriers to PrEP adoption among Black women at high risk for HIV: a qualitative exploration.

Authors
  • Nydegger, Liesl A1
  • Dickson-Gomez, Julia2
  • Ko, Thant Ko3
  • 1 Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA.
  • 2 Department of Epidemiology, Medical College of Wisconsin, Milwaukee, WI, USA.
  • 3 Institute for Health Equity, Medical College of Wisconsin, Milwaukee, WI, USA.
Type
Published Article
Journal
Culture, health & sexuality
Publication Date
May 01, 2021
Volume
23
Issue
5
Pages
659–673
Identifiers
DOI: 10.1080/13691058.2020.1720297
PMID: 32212993
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

In the USA, Black women are at disproportionately higher risk for HIV compared to women of other races/ethnicities, which can be explained by the Substance Abuse, Violence and AIDS (SAVA) syndemic. Disparities in HIV, substance use and violence are driven by multiple influences, including structural factors (e.g. housing and poverty), which exacerbate social- and individual-level factors leading to more sex partners, engaging in unprotected sex, having sex for money, experiencing forced sex from an intimate partner or increased substance use, all of which increase HIV risk. Pre-exposure prophylaxis (PrEP), a pill that can prevent HIV, is a discreet and underutilised method that Black women experiencing syndemics can use to decrease their risk. This study explored Black women's interest in, and barriers to adopting PrEP over 6 months. Thirty Black women (age M = 32.2) who experienced multiple substance use, violence and HIV-related syndemic factors were interviewed four times over a 6-month period. Results demonstrated that experiencing intimate partner violence, substance use, community violence and other structural factors (poor access to social services, transport and childcare) all acted as barriers to PrEP adoption. Future research should consider multi-level interventions that include methods such as media campaigns, providing PrEP or referrals where women who experience syndemic and structural factors seek help, and implement a PrEP adherence programmes and interventions in support group settings.

Report this publication

Statistics

Seen <100 times