Prioritizing Barriers and Facilitators to PrEP Uptake Among Black Cisgender Women: Key Factors Identified Through

Amber I Sophus1,2, Alex Dubov2,3, Aaliyah Gray2,4

  • 1Department of Health, Behavior, and Society, Kate Marmion School of Public Health, University of Texas at San Antonio, San Antonio, TX 78229, USA.

Existing research has identified multi-level barriers and facilitators associated with pre-exposure prophylaxis (PrEP) uptake among Black women (BW); little is known about how BW prioritize these factors. In this study, Nominal Group Technique (NGT) was used to identify and prioritize key barriers and facilitators influencing BW's potential use of PrEP. NGT sessions were conducted in two online focus groups with adult BW without HIV (N = 14). Participants ranked 16 barriers and 16 facilitators related to PrEP, by importance from 1 to 16, followed by a group discussion to review rankings, clarify reasons, and consolidate options. Participants also offered suggestions to enhance PrEP uptake for BW. Top concerns about PrEP were (1) side effects; (2) potential interactions with other medications; and (3) lack of health insurance coverage for PrEP. Key factors influencing PrEP use included: (1) discussing PrEP with a doctor of the same race; (2) discussing PrEP with a doctor of the same gender; and (3) receiving regular text or email reminders to take PrEP. Participants emphasized the importance of having race- and gender-concordant providers, which significantly influenced their consideration of PrEP. Using NGT as a qualitative exploratory method, this study underscores the importance of addressing key barriers and facilitators to PrEP uptake among BW.

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