Roth Alexis M, Ward Kathleen M, McDowell Erin, Forman Elana, Amico K Rivet, Bartholomew Tyler S, Krakower Douglas, Vader Daniel, Mazzella Silvana, Carrico Adam W, Sherman Susan G, Groves Allison
Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, 3215 Market Street, Philadelphia, PA, 19104, USA.
Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA.
AIDS Behav. 2025 Aug 6. doi: 10.1007/s10461-025-04833-5.
Long-acting injectable PrEP was approved for use in the US in 2021 but roll out has been slow, with few studies exploring uptake among cisgender women who inject drugs (WWID). We purposively recruited 25 WWID within 30-days of receiving a PrEP prescription from a low-barrier clinic co-located with a syringe services program to complete semi-structured interviews about PrEP product choice. We used an intersectional lens to compare decision-making between women choosing injectable PrEP versus oral PrEP and continued enrolling new participants until we reached thematic saturation (12/2022 to 2/2024). Participants represent a diverse sample of WWID (12 women of color) with median age 43 years. Daily injection drug use (72%) and ≥ 1 sex partner (64%) were common. Salient themes from interviews include: (1) PrEP provides women with a valued safety net and initiation is a form of self-preservation. (2) Co-located care, small incentives, and provider respect for WWID's medical autonomy helped participants navigate a multi-visit PrEP intake process. (3) Longer lasting HIV protection with less frequent dosing is preferrable to a shorter acting daily oral medication. When selecting a product, WWID evaluated its attributes against their medical history and personal circumstances like homelessness (64%). Most chose CAB-LA (72%) because it provides longer lasting protection which was a highly valued product attribute. Together, our findings underscore the critical importance of offering multiple PrEP options when implementing HIV prevention strategies that are patient-centered and responsive to the unique needs of WWID.
长效注射用暴露前预防药物（PrEP）于2021年在美国获批使用，但推广速度缓慢，很少有研究探讨注射毒品的顺性别女性（WWID）对其的接受情况。我们从一家与注射器服务项目同址的低门槛诊所招募了25名在收到PrEP处方后30天内的WWID，以完成关于PrEP产品选择的半结构化访谈。我们采用交叉性视角，比较选择注射用PrEP与口服PrEP的女性之间的决策过程，并持续招募新参与者，直至达到主题饱和（2022年12月至2024年2月）。参与者代表了多样化的WWID样本（12名有色人种女性），中位年龄为43岁。每日注射吸毒（72%）和有≥1名性伴侣（64%）的情况很常见。访谈中的突出主题包括：（1）PrEP为女性提供了重要的安全保障，开始使用是一种自我保护形式。（2）同址护理、小额激励措施以及提供者对WWID医疗自主权的尊重，帮助参与者完成了多次PrEP摄入过程。（3）与作用时间较短的每日口服药物相比，更长效且给药频率更低的HIV防护措施更受青睐。在选择产品时，WWID会根据自己的病史和个人情况（如无家可归，占64%）来评估产品属性。大多数人选择了卡博特韦长效注射剂（CAB-LA，占72%），因为它能提供更持久的保护，这是一个非常重要的产品属性。总之，我们的研究结果强调了在实施以患者为中心、满足WWID独特需求的HIV预防策略时，提供多种PrEP选择的至关重要性。
