Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California.
Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California.
Womens Health Issues. 2024 May-Jun;34(3):241-249. doi: 10.1016/j.whi.2023.11.001. Epub 2024 Jan 23.
African American women are disproportionately at risk for HIV infection. To increase women's readiness to consider taking pre-exposure prophylaxis (PrEP), we conducted a pilot study of Women Prepping for PrEP Plus (WP3+). Adapted from an evidence-based HIV risk reduction intervention for African American couples who are HIV-serodiscordant, WP3+ is a group-based culturally congruent program designed for African American women without HIV.
Women were screened for eligibility; if eligible, they were invited to participate in the four-session WP3+ group. Participants completed surveys at baseline (n = 47) and post-implementation (n = 28); surveys assessed demographics, HIV and PrEP knowledge, depression and posttraumatic stress (PTS) symptoms, substance use, sexual risk behaviors, health care-related discrimination, and social support. In a process evaluation, a subset of women completed qualitative interviews at baseline (n = 35) and post-implementation (n = 18); the interviews were designed to converge with (e.g., on HIV and PrEP knowledge) and expand upon (e.g., unmeasured perceived impacts of WP3+) quantitative measures. To triangulate with the quantitative data, deductive qualitative analysis concentrated on women's knowledge and awareness of PrEP and HIV, their relationship dynamics and challenges, and their considerations (e.g., barriers, facilitators) related to taking PrEP; inductive analysis focused on women's experiences in the intervention.
Participants in the WP3+ intervention reported: improved proportion of condom use in the past 90 days (p < .01) and in a typical week (p < .05); reduced PTS symptoms (p < .05); increased HIV knowledge (p < .0001) and awareness of PrEP (p < .001); and greater consideration of using PrEP (p < .001). In interviews, participants expressed not only increased knowledge but also appreciation for learning how to protect themselves against HIV, communicate with their partners, and take charge of their health, and they expressed greater receptiveness to using PrEP as a result of the knowledge and skills they gained.
The WP3+ pilot study demonstrated preliminary efficacy and acceptability as an HIV-prevention program for African American women. A controlled trial is needed to confirm its efficacy for increasing PrEP use among African American women.
非裔美国女性感染 HIV 的风险不成比例地高。为了提高女性对考虑使用暴露前预防（PrEP）的准备程度，我们对 Women Prepping for PrEP Plus（WP3+）进行了一项试点研究。WP3+改编自针对 HIV 血清不一致的非裔美国夫妇的基于证据的 HIV 风险降低干预措施，是为没有感染 HIV 的非裔美国女性设计的基于小组的文化上一致的方案。
对女性进行资格筛选；如果符合条件，邀请她们参加四节 WP3+小组。参与者在基线（n=47）和实施后（n=28）完成调查；调查评估了人口统计学、HIV 和 PrEP 知识、抑郁和创伤后应激（PTS）症状、物质使用、性风险行为、与医疗保健相关的歧视和社会支持。在一项过程评估中，一部分女性在基线（n=35）和实施后（n=18）完成了定性访谈；这些访谈旨在与（例如，HIV 和 PrEP 知识）相吻合，并扩展（例如，WP3+的未测量的感知影响）定量措施。为了与定量数据进行三角验证，演绎定性分析集中在女性对 PrEP 和 HIV 的了解和认识、她们的关系动态和挑战，以及她们与服用 PrEP 相关的考虑因素（例如，障碍、促进因素）；归纳分析则集中在女性在干预中的经历。
WP3+干预组的参与者报告：过去 90 天内（p<.01）和典型周内（p<.05）使用避孕套的比例增加；PTS 症状减轻（p<.05）；HIV 知识（p<.0001）和 PrEP 意识（p<.001）提高；并且更考虑使用 PrEP（p<.001）。在访谈中，参与者不仅表达了增加的知识，还表达了对学习如何保护自己免受 HIV 感染、与伴侣沟通以及掌握自己健康的感激之情，并且由于他们获得的知识和技能，他们对使用 PrEP 更加接受。
WP3+试点研究表明，该方案作为非裔美国女性的 HIV 预防方案具有初步的疗效和可接受性。需要进行对照试验来确认其增加非裔美国女性使用 PrEP 的效果。
