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Pre-exposure prophylaxis awareness, interest, and modality preferences to prevent HIV among cisgender women in the Dominican Republic and the United States

Year: 2026

Type: article

Abstract: Introduction: Significant inequities in HIV incidence and prevalence exist among cisgender women (hereafter women), including a disproportionate burden of the epidemic among Black women in the United States and female sex workers globally. Women have limited awareness of and access to pre-exposure prophylaxis (PrEP) for HIV pharmacoprevention. Methods: = 602) in 2022-2023. Thematic analysis andmultivariate regression were utilized. Results: Across settings, women were aged ≥18 years and HIV-negative; most were Black or multiracial, single, in their 30s, with >1 child. In IDIs, women characterized PrEP as an empowerment tool and welcomed modality options; HCPs across sites relayed a lack of comfort and preparation to address the unique needs of women and discuss LAI PrEP. In surveys, women reported low PrEP awareness and use: 29% (DC) and 6% (DR) had heard of daily oral PrEP, <6% had heard of LAI PrEP across sites, and 3% (DC) and 1% (DR) had ever used PrEP. Strong interest in taking PrEP varied (DC, 5%; DR, 80%). Modality preferences were similar, with most preferring LAI vs. daily oral PrEP (DC, 73%; DR, 71%). Across sites, preference for LAI PrEP was inversely associated with concern for injection pain/tenderness. In DC, LAI preference was associated with a higher score on a PrEP optimization/ considerations scale. In the DR, LAI preference was associated with injectable medication/contraception experience and alcohol use and inversely associated with PrEP stigma and partner violence. Discussion: Diverse groups of women have shared and unique drivers of PrEP modality preferences which should be considered when developing and tailoring multi-level interventions to promote PrEP awareness and uptake among women. These interventions should address social determinants and side effects and include HCP training and tools that promote shared decision-making.

Source: Frontiers in Global Women s Health

DOI: 10.3389/fgwh.2026.1817411