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J Int AIDS Soc. 2019 Mar;22(3):e25247. doi: 10.1002/jia2.25247.

Perspectives of US women participating in a candidate PrEP study: adherence, acceptability and future use intentions.

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University of Michigan School of Public Health, Ann Arbor, MI, USA.
University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
University of Arkansas for Medical Sciences College of Public Health, Little Rock, AR, USA.
Johns Hopkins School of Nursing, Baltimore, MD, USA.
West Virginia University School of Medicine, Morgantown, WV, USA.
West Virginia Clinical and Translational Science Institute, Morgantown, WV, USA.
Rutgers New Jersey Medical School, Newark, NJ, USA.
Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
FHI360, Washington, DC, USA.
Fenway Health and Harvard Medical School, New York, NY, USA.
Weill Cornell Medicine, New York, NY, USA.



Limited data exist on acceptability of candidate pre-exposure prophylaxis (PrEP) regimens among US women. We evaluated PrEP experiences, attitudes and future use intentions among sexually active women who completed the US-based HIV Prevention Trials Network 069/AIDS Clinical Trials Group 5305 study.


Women participated in the study between March 2013 and November 2015. We analysed computer-assisted self-interview (CASI) surveys among 130 women and conducted in-depth interviews among a subset of 26 women from three sites. Interviews were conducted in mid/late-2015.


Most women (57%) reported very good/excellent PrEP adherence on CASI, although 21% acknowledged over-reporting adherence at least some of the time. Commitment to preventing HIV infection, a sense of ownership of the study, and keeping pills stored in a visible location facilitated adherence. Adherence barriers included "simply forgetting" and being away from home. Most women interviewed did not intend to use PrEP in the future because of lack of perceived need due to their own (as opposed to their partners') low-risk behaviour and concerns about affordability - but not because of side effects or other characteristics of the regimens.


Improving HIV prevention options for US women will require access to affordable PrEP as well as expanding women's understanding of relationship- and community-level factors that increase their risk of acquiring HIV.


HIV prevention; PrEP; United States; risk perception; women

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