A Qualitative Study Exploring How the Perspectives and Experiences of Cisgender Black Women Inform Their Readiness to Consider Pre-Exposure Prophylaxis for HIV Prevention

Attention to increasing pre-exposure prophylaxis (PrEP) use among cisgender Black women (CBW) in the southern United States (U.S.) is necessary to achieve national 2030 Ending the HIV Epidemic (EHE) goals. Qualitative exploration of CBW's readiness to use PrEP is necessary to discern whether practical solutions to addressing PrEP uptake within this HIV-vulnerable population are feasible. Focus group discussions (n = 5) and key informant interviews (n = 3) in two EHE jurisdictions in Houston and Austin, Texas were used to explore how perspectives and lived experiences may serve as facilitators and/or barriers to PrEP readiness among 20 CBW. Codes highlighted facilitators and barriers to PrEP readiness. Facilitators involved positive experiences with the healthcare system, high perceived HIV vulnerability, and prioritizing PrEP as self-care. Barriers encompassed concerns with sexual relationship dynamics, mental health implications, and access to humane treatment within the healthcare system. High perceived vulnerability of HIV acquisition is related to an awareness that CBW may not know the entirety of their partner's sexual activities. Findings indicate precursors of PrEP readiness and challenge the notion that CBW have low perceived vulnerability of acquiring HIV.