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Perspectives on HIV pre-exposure prophylaxis (PrEP) implementation in Mississippi among Black women and clinical staff: Recommendations for clinical trauma-informed programs

Year: 2023
Type: article
Abstract: Intimate partner violence (IPV) can constraint Black women's ability to prioritize and access Human Immunodeficiency Virus (HIV) pre-exposure prophylaxis (PrEP) services. Recent research has called for the development of trauma-informed PrEP implementation programs to improve the delivery of PrEP to Black cisgender women; however, many PrEP-prescribing settings do not reflect this recommendation. The current study sought to identify key components to develop a trauma-informed PrEP implementation program for Black cisgender women and clinical staff. We conducted focus groups with PrEP-eligible Black cisgender women (February-June 2019), and semi-structured interviews with clinical staff offering HIV prevention and treatment services (October-November 2020) in community healthcare clinics in Mississippi. Seven themes were identified as needed to facilitate integration of trauma-informed approaches into existing PrEP programs, including defining intimate partner violence (IPV), appropriate IPV screening and response, HIV prevention in abusive relationships, staff training needs, and creating supportive clinic environments. PrEP-eligible Black women and clinical staff generally agreed on how to best operationalize IPV screening and response, the importance of trauma-informed staff training, and the need for Black women-specific informational campaigns. However, Black women highlighted the need for providers to discuss HIV prevention in controlling relationships, and to respond to IPV disclosure. HIV pre-exposure prophylaxis has yet to achieve the potential impact observed in trials. Ultimately, realizing the HIV prevention potential of PrEP in the US necessitates centering the perspectives of Black cisgender women and staff to better integrate trauma-informed approaches.
DOI: 10.1016/j.pmedr.2023.102490
Authors: Tiara C. Willie, Karlye Phillips, Aashna Shah, M.P.H. Mauda Monger, Amy Nunn, Trace Kershaw, Philip A. Chan, Stefan D. Baral, Kenneth H. Mayer, Adaora A. Adimora, Leandro A. Mena, Jamila K. Stockman
Institutions: Johns Hopkins University, Brown University, Yale University, Harvard University, University of North Carolina at Chapel Hill, University of Mississippi Medical Center, University of California San Diego
Language: English
Field: Medicine
Open Access status: gold
Estimated APC paid: $2,720
Funders: Johns Hopkins University, National Institutes of Health, Center for AIDS Research, University of Washington, Center for AIDS Research, Johns Hopkins University, National Institute of Mental Health, National Institute on Drug Abuse, National Institute of Allergy and Infectious Diseases, National Center for Advancing Translational Sciences, National Institute on Minority Health and Health Disparities
Awards: Using Implementation Science to Increase PrEP Uptake among African American Women in the South, G2483435703, G5356377628, The UCLA HIV/AIDS, Substance Abuse, and Trauma Training Program, G610555593, G6504474358, G653582874, G7178514535, San Diego Center for AIDS Research (SD CFAR), The Johns Hopkins Center for AIDS Research (JHU CFAR), Brown University Community and Clinical Research Training Program, Yale Clinical and Translational Science Award
OpenAlex ID: W4388366297
FWCI: 2.88
Cites: 31
Cited by: 14
Related to: 10