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Interest in Long-Acting Injectable Pre-exposure Prophylaxis (LAI PrEP) Among Women in the Women’s Interagency HIV Study (WIHS): A Qualitative Study Across Six Cities in the United States

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Abstract

Long-acting injectable (LAI) pre-exposure prophylaxis (PrEP) has the potential to facilitate adherence and transform HIV prevention. However, little LAI PrEP research has occurred among women, who face unique barriers. We conducted 30 in-depth interviews with HIV-negative women from 2017–2018 across six sites (New York; Chicago; San Francisco; Atlanta; Washington, DC; Chapel Hill) of the Women’s Interagency HIV Study. Interviews were recorded, transcribed, and analyzed using thematic content analysis. Few women expressed interest in PrEP and when prompted to choose a regimen, 55% would prefer LAI, 10% daily pills, and 33% said they would not take PrEP regardless of formulation. Perceived barriers included: (1) the fear of new—and perceived untested—injectable products and (2) potential side effects (e.g., injection-site pain, nausea). Facilitators included: (1) believing shots were more effective than pills; (2) ease and convenience; and (3) confidentiality. Future studies should incorporate women’s LAI PrEP-related experiences to facilitate uptake.

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Notes

  1. Ages are reported in ranges by decade, rather than specific ages, in order to maintain participant confidentiality.

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Funding

The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH). MWCCS (Principal Investigators): Atlanta CRS (Ighovwerha Ofotokun, Anandi Sheth, and Gina Wingood), U01-HL146241; Bronx CRS (Kathryn Anastos and Anjali Sharma), U01-HL146204; Data Analysis and Coordination Center (Gypsyamber D’Souza, Stephen Gange and Elizabeth Golub), U01-HL146193; Chicago-Cook County CRS (Mardge Cohen and Audrey French), U01-HL146245; Connie Wofsy Women’s HIV Study, Northern California CRS (Bradley Aouizerat and Phyllis Tien), U01-HL146242; Metropolitan Washington CRS (Seble Kassaye and Daniel Merenstein), U01-HL146205; Miami CRS (Maria Alcaide, Margaret Fischl, and Deborah Jones), U01-HL146203; UNC CRS (Adaora Adimora), U01-HL146194. The MWCCS is funded primarily by the National Heart, Lung, and Blood Institute (NHLBI), with additional co-funding from the Eunice Kennedy Shriver National Institute Of Child Health & Human Development (NICHD), National Institute On Aging (NIA), National Institute Of Dental & Craniofacial Research (NIDCR), National Institute Of Allergy And Infectious Diseases (NIAID), National Institute Of Neurological Disorders And Stroke (NINDS), National Institute Of Mental Health (NIMH), National Institute On Drug Abuse (NIDA), National Institute Of Nursing Research (NINR), National Cancer Institute (NCI), National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute on Deafness and Other Communication Disorders (NIDCD), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institute on Minority Health and Health Disparities (NIMHD), and in coordination and alignment with the research priorities of the National Institutes of Health, Office of AIDS Research (OAR). MWCCS data collection is also supported by UL1-TR000004 (UCSF CTSA), P30-AI-050409 (Atlanta CFAR), P30-AI-050410 (UNC CFAR), and P30-AI-027767 (UAB CFAR). Dr. Philbin is supported by K01DA039804A.

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Authors and Affiliations

  1. Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA

    Morgan M. Philbin, Carrigan Parish, Elizabeth N. Kinnard, Sarah E. Reed & Lisa R. Metsch

  2. Department of Sociology, American University, Washington, D.C., USA

    Deanna Kerrigan

  3. Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA

    Maria L. Alcaide & Margaret Fischl

  4. Departments of Medicine/CORE Center at John H. Stroger, Cook County Health & Hospital System, Jr Hospital of Cook County, Chicago, IL, USA

    Mardge H. Cohen

  5. Department of Medicine, Montefiore, Bronx, NY, USA

    Oluwakemi Sosanya

  6. Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA

    Anandi N. Sheth

  7. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Adaora A. Adimora

  8. Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC, USA

    Adaora A. Adimora

  9. Department of Clinical Pharmacy, University of California at San Francisco School of Pharmacy, UCSF, San Francisco, CA, USA

    Jennifer Cocohoba

  10. Department of Medicine, Georgetown University Medical Center, Washington, D.C., USA

    Lakshmi Goparaju

  11. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Elizabeth T. Golub

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  1. Morgan M. Philbin
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Correspondence to Morgan M. Philbin.

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Conflict of interest

Adaora A. Adimora-has received funding from Viiv, Merck, and Gilead, including a grant from Gilead; Anandi N. Sheth declares that Gilead has given research grants to her institution, but none are related to her current work. For the remaining authors none were declared.

Ethical Approval

IRB approval was obtained at all participating sites prior to interview initiation. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in the study prior to the interview.

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Philbin, M.M., Parish, C., Kinnard, E.N. et al. Interest in Long-Acting Injectable Pre-exposure Prophylaxis (LAI PrEP) Among Women in the Women’s Interagency HIV Study (WIHS): A Qualitative Study Across Six Cities in the United States. AIDS Behav 25, 667–678 (2021). https://doi.org/10.1007/s10461-020-03023-9

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