“We Feel Like Everybody's Going to Judge us”: Black Adolescent Girls’ and Young Women's Perspectives on Barriers to and Opportunities for Improving Sexual Health Care, Including PrEP, in the Southern U.S

• Authors: Madeline C. Pratt, Heersink School of Medicine; Seabrook Jeffcoat, Haverford College; Samantha Hill, Emory University; Elizabeth Gill, Heersink School of Medicine; Latesha Elopre, Heersink School of Medicine; Tina Simpson, Heersink School of Medicine; Robin Lanzi, University of Alabama at Birmingham School of Public Health; Lynn T. Matthews, Heersink School of Medicine
• Journal Title: Journal of the International Association of Providers of AIDS Care
• Volume: Volume 21
• Publisher: (publisher) | 2022-01-01, Pages 23259582221107327-23259582221107327
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1177/23259582221107327
• Subjects: Biology, Virology; Health Sciences, Public Health; Psychology, Behavioral
• Keywords: HIV pre-exposure prophylaxis; U.S. South; adolescents; sexual health; women and girls; Adolescent; Adult; Anti-HIV Agents; Black People; Female; HIV Infections; Humans; Pre-Exposure Prophylaxis; Sexual Behavior; Sexual Health; Sexual Partners; Young Adult

Abstract

Black adolescent girls and young women (AGYW) are disproportionately affected by HIV in the southern U.S.; however, PrEP prescriptions to Black AGYW remain scarce. We conducted in-depth interviews (IDIs) with Black AGYW ages 14-24 in Alabama to explore opportunities for and barriers to sexual health care including PrEP prescription. Twelve AGYW participated in IDIs with median age 20 (range 19-24). All reported condomless sex, 1-3 sexual partners in the past 3 months, and 6 reported prior STI. Themes included: 1) Stigma related to sex contributes to inadequate discussions with educators, healthcare providers, and parents about sexual health; 2) Intersecting stigmas around race and gender impact Black women's care-seeking behavior; 3) Many AGYW are aware of PrEP but don't perceive it as an option for them. Multifaceted interventions utilizing the perspectives, voices, and experiences of Black cisgender AGYW are needed to curb the HIV epidemic in Alabama and the U.S. South.