Sharma Acacia, Revees Jaquetta, Heron Kristin, Shangani Sylvia
Department of Community Health Sciences, School of Public Health, Boston University, Boston, MA, USA.
Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA.
AIDS Care. 2025 Apr 14:1-9. doi: 10.1080/09540121.2025.2487218.
Black cisgender women in the U.S. South experience a significant disparity in HIV infection rates. Pre-exposure Prophylaxis (PrEP) is an effective medication that can reduce HIV risk but is underutilized among Black women. We assessed the association between setting and PrEP awareness and acceptability in Black cisgender women in the U.S. South. A cross-sectional online survey was administered from March to June 2022 to HIV-negative Black cisgender women living in the Southern United States. Participants reported demographic information, PrEP awareness, likelihood of PrEP use, HIV knowledge, risk perception, and healthcare access. Logistic regression models assessed correlates of PrEP awareness and acceptability. Of 491 participants (Mean age = 40.42 [SD = 17.5], 20.0% rural, 80.0% urban/suburban), 44.9% of rural and 38.2% of urban/suburban participants were PrEP aware. 44.9% of rural versus 36.1% of urban/suburban participants were likely to use PrEP. Rural Black women reported higher PrEP acceptability (adjusted odds ratio [aOR] = 1.96, 95% CI 1.20, 3.18, = 0.01). Having health insurance (aOR = 2.43, 95% CI 1.28, 4.65, = 0.01) and younger age (aOR = 0.98, 95% CI 0.96, 0.99, < 0.001) were associated with PrEP acceptability. To improve PrEP awareness, acceptability, and uptake, intervention programs should be tailored to individuals' geographical circumstances and needs.
美国南部的黑人顺性别女性在艾滋病毒感染率方面存在显著差异。暴露前预防（PrEP）是一种有效的药物，可以降低感染艾滋病毒的风险，但在黑人女性中未得到充分利用。我们评估了美国南部黑人顺性别女性所处环境与PrEP知晓率及可接受性之间的关联。2022年3月至6月，对居住在美国南部的艾滋病毒阴性黑人顺性别女性进行了一项横断面在线调查。参与者报告了人口统计学信息、PrEP知晓情况、使用PrEP的可能性、艾滋病毒知识、风险认知和医疗保健获取情况。逻辑回归模型评估了PrEP知晓率和可接受性的相关因素。在491名参与者中（平均年龄 = 40.42 [标准差 = 17.5]，20.0%为农村人口，80.0%为城市/郊区人口），44.9%的农村参与者和38.2%的城市/郊区参与者知晓PrEP。44.9%的农村参与者与36.1%的城市/郊区参与者可能使用PrEP。农村黑人女性报告的PrEP可接受性更高（调整后的优势比[aOR] = 1.96，95%置信区间1.20，3.18，P = 0.01）。拥有医疗保险（aOR = 2.43，95%置信区间1.28，4.65，P = 0.01）和年龄较小（aOR = 0.98，95%置信区间0.96，0.99，P < 0.001）与PrEP可接受性相关。为了提高PrEP的知晓率、可接受性和使用率，干预项目应根据个人的地理环境和需求进行调整。
