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"Why not take that pill?": A Mixed-Methods Study of Gender, Risk Perception, and PrEP Uptake Among Drug-Involved
Dawn Goddard-Eckrich1, Srishti Meera Sardana2, Brandy F Henry3
1The Social Intervention Group, Columbia University, School of Social Work, 1255 Amsterdam Avenue, Room 801, NY, 10027, New York, USA. dg2121@columbia.edu.
A couples HIV intervention improved condom use intentions among drug-using men on community supervision and their partners. The PACT intervention also increased female partners' pre-exposure prophylaxis (PrEP) use intentions.
Area of Science:
- Public Health
- HIV Prevention
- Behavioral Science
Background:
- Individuals under community supervision who use drugs have a higher risk of HIV infection.
- Understanding factors influencing pre-exposure prophylaxis (PrEP) acceptance is crucial for this population.
Purpose of the Study:
- To examine PrEP acceptance among community-supervised men who use drugs and their female partners using a mixed-methods approach.
- To evaluate the impact of a couples' HIV intervention (PACT) on PrEP willingness and condom use intentions.
Main Methods:
- A randomized controlled trial involving 394 participants randomized to either the PACT intervention or a control group.
- Qualitative interviews with 20 couples (40 individuals) to explore attitudes towards PrEP.
- Quantitative assessment of condom use and PrEP use intentions.
Main Results:
- The PACT group showed significantly higher intentions to use condoms with PrEP (64% vs. 53%, p=0.03).
- Female partners in the PACT intervention had stronger PrEP use intentions (aOR=2.85, p=0.02).
- Key factors influencing PrEP acceptance included infidelity concerns, substance use, HIV fears, low-risk perception, and medical mistrust.
Conclusions:
- Gender significantly influences PrEP acceptance in couples involved with the criminal legal system.
- Interventions should address gender differences, risk perception, and medical mistrust to improve PrEP uptake.
- The PACT intervention shows promise in enhancing HIV prevention behaviors within this high-risk population.
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