Theme: Clinical Research Year: 2024
Background: PrEP, PEP, and PEP-in-pocket (PIP) are medications that effectively prevent HIV, yet HIV rates are increasing among women; and studies have shown significantly lower PrEP-to-need ratio among women compared to men. This study assesses women’s HIV risk and prophylaxis awareness and access.
Methods: This cross-sectional, 52-question survey was offered to women in community settings in Ontario, Canada, who self-identified as sexually active with no experience with HIV prophylaxis. Differences in demographic and socioeconomic characteristics and knowledge of HIV prophylaxis by self-assessed HIV risk were evaluated. Age-adjusted multivariable logistic regression was used to analyze the association between sexual and drug use-related HIV risk and self-assessed HIV risk.
Results: 278 responses were included in the analysis, and 259 (93.2%) assessed themselves at low/average risk for HIV, while 19 (6.8%) identified themselves as higher risk. The high-risk group had a larger proportion of women <27 years (36.8% vs 19.3%). Using adjusted multivariable regression, women who self-reported at least one sexual risk factor (50.6% vs 89.5%, aOR 4.7, p = 0.06), and women who self-reported at least one drug risk factor (29.3% vs 68.4%, aOR 3.0, p = 0.05) were more likely to place themselves in the high-risk group. Knowledge and awareness of PrEP, PEP, and PIP was lower in the low self-assessed risk group (48.3%, 47.9%, 23.9% respectively) compared to the high-risk group (57.9%, 52.6%, 36.8% respectively), though these differences were not significant. Similarly, prior PrEP and PEP offers were reported by the high self-assessed risk group (10.5% and 10.5% respectively) more frequently to the low self-assessed risk group (6.6% and 6.2%), though not significantly.
Conclusions: Self-assessed risk was associated with sexual and drug risk factors, but awareness of prophylaxis options and reported prior PrEP/PEP offer was low across groups. These findings support the need for increased awareness, especially among women who already understand their risk.
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