Factors associated with HIV pre-exposure prophylaxis awareness and use among women aged 40–65 years in South East England: an analysis of the ‘Health Counts 2024’ survey

HIV diagnoses are increasing among women in the UK. Granular data on midlife women’s (women aged 40-65 years) knowledge about, and access to HIV Pre-Exposure Prophylaxis (PrEP), an effective chemoprophylactic strategy for HIV, is lacking. Data from a 2024 population health survey of an English city (Brighton & Hove) were analysed to describe the sexual health behaviours of midlife women (cis and transgender), and to investigate whether sociodemographic and/ or sexual behaviour factors were associated with PrEP awareness and use. Although only 37.5% (n=66) of the participants who had a new sexual partner in the last year reported that they had used a condom for every sexual encounter, awareness and use of PrEP was low. Among the 3,335 midlife women, 1,013 (30.4%) were aware of PrEP and 12 (1.2%) had used or were using PrEP. Poor PrEP awareness was associated with older age; heterosexual identity; not living with a long term physical or mental health condition; Asian or Asian British ethnicity; not having received a university-level education; having had fewer sexual partners and never having had an HIV test. National disaggregation of the sociodemographic and sexual behaviour associations with PrEP awareness among midlife women, and an understanding of how this translates to PrEP use is required to enable better targeting of HIV prevention interventions.