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Awareness, Acceptability, and Preferences for Pre-exposure Prophylaxis Modalities Among Black Women: A Critical
Gloria Aidoo-Frimpong1, Laurenia C Mangum2, Amber I Sophus3
1Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, SUNY, and the Center for Interdisciplinary Research on AIDS, Yale University, New Haven, Connecticut.
Black women experience a disproportionate burden of human immunodeficiency virus in the United States, yet use of pre-exposure prophylaxis remains low. This article critically reviews published research on barriers to and facilitators of pre-exposure prophylaxis acceptability among Black women and presents findings from a qualitative pilot study examining awareness and preferences for available and emerging prevention modalities. A critical review of 50 peer-reviewed studies published between 2012 and 2025 identified persistent challenges as well as facilitators. The pilot study included focus groups and interviews with 20 pre-exposure prophylaxis-naïve Black women in two high-incidence Texas counties. Participants demonstrated limited awareness of injectable prevention options, varied preferences across modalities, and strong interest in expanded delivery settings such as pharmacies, mobile services, and at-home options. Findings indicate that low uptake reflects structural gaps in prevention systems rather than lack of interest, underscoring the need for diversified modalities and accessible delivery models.
Black women experience a disproportionate burden of human immunodeficiency virus in the United States, yet use of pre-exposure prophylaxis remains low. This article critically reviews published research on barriers to and facilitators of pre-exposure prophylaxis acceptability among Black women and presents findings from a qualitative pilot study examining awareness and preferences for available and emerging prevention modalities. A critical review of 50 peer-reviewed studies published between 2012 and 2025 identified persistent challenges as well as facilitators. The pilot study included focus groups and interviews with 20 pre-exposure prophylaxis-naïve Black women in two high-incidence Texas counties. Participants demonstrated limited awareness of injectable prevention options, varied preferences across modalities, and strong interest in expanded delivery settings such as pharmacies, mobile services, and at-home options. Findings indicate that low uptake reflects structural gaps in prevention systems rather than lack of interest, underscoring the need for diversified modalities and accessible delivery models.
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