Let me tell you what we want! Qualitative considerations for expanding HIV Prevention using digital strategies among a sample of Black women at risk for HIV in rural America, US


BACKGROUND: Black women in the United States are continuously and disproportionately affected by HIV, comprising nearly 60% of incident diagnoses. The Centers for Disease Control and Prevention indicated that half million women could benefit from the use of PrEP to prevent HIV acquisition. Despite this, Black women represent less than 1% of PrEP users. Considerations for expanded biomedical HIV prevention strategies have largely focused on key populations of women in the Western, Southern, and Northeastern regions of the US, effectively omitting women in rural America, US, who are also disproportionately impacted by HIV.
DESCRIPTION: This qualitative study aimed to
1) assess Black women's perceptions of knowledge and awareness of PrEP to
2) inform components of a digital strategy designed to increase Black women's knowledge and awareness of PrEP in rural geographies using the community based organization as a tool for innovation.
LESSONS LEARNED: By and large, Black women were unaware of PrEP as a biomedical HIV prevention strategy. Women reported feelings of social disadvantage and being 'left behind' other populations who have access to and benefited from PrEP use since being approval for use. Participants advised that any digital strategies aimed at increasing Black women's knowledge and awareness of PrEP should center women's sexual health empowerment and paradigms of sex positivity, and not focus on risk, disease, and fear. Digital components should include a diverse representation of Black women across age, skin color, weight, and sexual orientation. Multiple engagement platforms should be utilized to disseminate the information to Black women by community based organizations with trusted relationships with Black women.
CONCLUSIONS: Development of digital marketing and education strategy specific to considerations provided by rural US Black women is currently underway. Results will inform the development of a PrEP focused mobile (m)Health application to bridge the GAP between women's lack of access and rate of utilization in historically underserved areas of the US highly impacted by HIV.