Using Motivational Interviewing to Increase PrEP Uptake Among Black Women at Risk for HIV: an Open Pilot Trial of MI-PrE
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Using Motivational Interviewing to Increase PrEP Uptake Among Black Women at Risk for HIV: an Open Pilot Trial of MI-PrEP Sannisha K. Dale 1 Received: 8 October 2019 / Revised: 27 January 2020 / Accepted: 27 January 2020 # W. Montague Cobb-NMA Health Institute 2020
Abstract Black women in the USA are at the highest risk among women for HIV. Pre-exposure prophylaxis (PrEP) prevents HIV transmission, but uptake among Black women remains low. An open pilot trial was conducted on MI-PrEP, a brief culturally tailored intervention incorporating motivational interviewing (MI) strategies to improve PrEP uptake and motivation. MI-PrEP is the first behavioral intervention developed to promote PrEP uptake among women in the USA. In Miami, FL, ten Black women who met eligibility criteria (e.g., sexual partner with HIV) were enrolled. These women participated in the two sessions of MIPrEP and a 1-month follow-up. Participants completed measures on PrEP (motivation, uptake [verified via medical records], adherence, and barriers), medical mistrust, and an exit interview. These preliminary findings showed acceptability and feasibility with high satisfaction ratings; increases in PrEP uptake, knowledge, and motivation to use; and decreases in PrEP barriers and medical mistrust. Greater attention is needed on the psychosocial and structural factors among Black women who may benefit from PrEP. Keywords Black women . HIV . Pre-exposure prophylaxis . Motivational interviewing . Intervention
Introduction In the USA, Black women are at the highest risk for contracting HIV in comparison with women of other racial/ ethnic groups [1], and HIV is the number one leading cause of death for Black women ages 25 to 34 [2, 3]. Pre-exposure prophylaxis (PrEP) is an antiretroviral pill (e.g., tenofovir disoproxil fumarate and emtricitabine) that if taken once per day by an HIV-negative individual, may protect that person from acquiring HIV from an HIV-positive sexual partner [1, 4]. For instance, researchers found that the efficacy of PrEP was 90% among women who adhered to PrEP as directed [5]. However, researchers also found that Black women in the USA were over four times less likely to have initiated PrEP, compared with White women [6]. There are unique cultural, social, and behavioral factors for Black women at risk for HIV Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40615-020-00715-9) contains supplementary material, which is available to authorized users. * Sannisha K. Dale [email protected] 1
Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL 33146, USA
in the USA that need to be considered for PrEP uptake and adoption. A review by Flash, Dale, and Krakower [7] discussed potential behavioral and social factors for PrEP uptake among US women including racism, medical mistrust, poverty, unstable housing, trauma and violence, and mental health struggles. In addition, brief interventions promoting PrEP uptake may be easier to implement and disseminate.
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