Sims-Haynes Alexis, Markham Christine, Schick Vanessa, Suchting Robert, Hill Mandy J
Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth Houston) School of Public Health, 1200 Pressler St, Houston, TX, 77030, USA.
Department of Management, Policy, and Community Health, The University of Texas Health Science Center at Houston (UTHealth Houston) School of Public Health, 1200 Pressler St, Houston, TX, 77030, USA.
J Racial Ethn Health Disparities. 2025 Jul 23. doi: 10.1007/s40615-025-02557-9.
Cisgender (cis) Black women in the USA face high HIV disparities, underscoring the need for effective prevention measures. Although pre-exposure prophylaxis (PrEP) is an effective preventive tool, its use remains limited. This study explored the correlates of PrEP readiness among substance-using cis Black women in Houston, Texas, highlighting its link with PrEP willingness. Using the motivational PrEP cascade as a framework, this cross-sectional secondary analysis, derived from a pilot randomized controlled trial (RCT), explored the relationship between PrEP readiness and willingness and discerned the unique determinants of this relationship. Baseline data included socio-demographics, condomless sex, substance use problems, and PrEP-related factors. Participants were recruited from two hospital emergency departments. Descriptive statistics, logistic regressions, and moderation analyses were conducted (n = 40). Among the 40 participants, 95% were knowledgeable about PrEP, but their readiness levels varied, with only 40% expressing willingness. Participants in Stage 3, or the preparation stage of PrEP readiness, were 1.6 times more likely to adopt PrEP and report a greater frequency of alcohol problems compared to participants in the pre-contemplation stage. Across all stages of readiness, participants' PrEP willingness increased the most in Stage 3, peaking at 83%. This study highlights the importance of PrEP readiness, especially the pivotal role of the third preparation stage, in the likelihood of substance-using cis Black women expressing a willingness to adopt PrEP, with frequent alcohol use emerging as a pivotal determinant. This study advocates for tailored PrEP interventions exploring readiness and motivation and more comprehensive behavioral risk assessments for Black women.
美国的顺性别黑人女性面临着严重的艾滋病毒差异问题，这凸显了采取有效预防措施的必要性。尽管暴露前预防（PrEP）是一种有效的预防工具，但其使用仍然有限。本研究探讨了德克萨斯州休斯顿使用毒品的顺性别黑人女性中PrEP准备情况的相关因素，强调了其与PrEP意愿的联系。以动机性PrEP级联为框架，这项横断面二次分析源自一项试点随机对照试验（RCT），探讨了PrEP准备情况与意愿之间的关系，并识别了这种关系的独特决定因素。基线数据包括社会人口统计学、无保护性行为、药物使用问题以及与PrEP相关的因素。参与者从两家医院急诊科招募。进行了描述性统计、逻辑回归和调节分析（n = 40）。在40名参与者中，95%了解PrEP，但他们的准备程度各不相同，只有40%表示愿意。处于PrEP准备的第3阶段或准备阶段的参与者采用PrEP的可能性是处于未考虑阶段的参与者的1.6倍，并且报告的酒精问题频率更高。在所有准备阶段中，参与者的PrEP意愿在第3阶段增加最多，峰值为83%。本研究强调了PrEP准备情况的重要性，特别是第三个准备阶段的关键作用，对于使用毒品的顺性别黑人女性表达采用PrEP的意愿而言，频繁饮酒成为一个关键决定因素。本研究倡导针对PrEP准备情况和动机进行量身定制的干预措施，以及对黑人女性进行更全面的行为风险评估。
Cochrane Database Syst Rev. 2023-12-12
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