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Women experiencing incarceration need better access to HIV pre-exposure prophylaxis (PrEP). Key barriers include stigma, competing priorities, and adherence challenges, highlighting the need for tailored interventions.

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Area of Science:

  • Public Health
  • Infectious Diseases
  • Criminal Justice Health

Background:

  • Women experiencing incarceration (WEI) face disproportionately high HIV rates in the U.S.
  • HIV pre-exposure prophylaxis (PrEP) remains underutilized among this population.
  • Effective interventions are needed to improve PrEP uptake during and after incarceration.

Purpose of the Study:

  • To inform the development of an intervention promoting PrEP initiation among WEI.
  • To identify strategies for facilitating linkage to community PrEP care post-release.
  • To understand barriers and facilitators to PrEP use in this population.

Main Methods:

  • Conducted individual, semistructured qualitative interviews.
  • Recruited 21 women experiencing incarceration (WEI).
  • Interviewed 14 key stakeholders involved in criminal justice and HIV care.

Main Results:

  • WEI reported limited prior knowledge of PrEP but recognized its potential benefit.
  • Barriers to PrEP initiation included HIV-related stigma and underestimation of personal HIV risk.
  • Post-release, competing priorities, appointment scheduling, and motivation impacted PrEP care linkage.

Conclusions:

  • WEI perceive PrEP as beneficial, but knowledge gaps and stigma are significant barriers.
  • Challenges in community linkage and adherence (cost, substance use, adherence) require targeted support.
  • Interventions should address these multifaceted barriers to improve PrEP access and adherence for WEI.