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Where’s the “Everyday Black Woman”? An intersectional qualitative analysis of Black Women’s decision-making regarding HIV pre-exposure prophylaxis (PrEP) in Mississippi

Citation

Willie TC, Knight D, Baral SD, et al. Where’s the “Everyday Black Woman”? An intersectional qualitative analysis of Black Women’s decision-making regarding HIV pre-exposure prophylaxis (PrEP) in Mississippi. BMC Public Health. 2022;22(1):1604. doi:10.1186/s12889-022-13999-9

Implementation stage:

Pre-Implementation

Implementation outcomes reported:

Not applicable

Continuum target addressed:

PrEP initiation, Linkage to preventative care

Geography:

Mississippi

Study Participant Classification:

Community member(s)

Plain Language Objectives

The researchers asked Black women in Jackson how social pressures, health care experiences, cost, stigma, and representation of Black women shaped their decisions about whether to consider PrEP.

Plain Language Abstract

Black cisgender women in the southern United States experience disproportionate HIV burden, yet pre-exposure prophylaxis, or PrEP, remains underused. Researchers conducted six focus groups with 37 PrEP-eligible Black women in Jackson, Mississippi, who had never received a prescription. Participants described six concerns: limited awareness, low perceived HIV risk, possible side effects, cost, little marketing directed to Black women, and distrust of the health system. They also identified three supports for considering PrEP: women’s empowerment and advocacy, more PrEP-specific education, and testimonials from Black women already using it. Participants connected limited awareness to the lack of visible, relevant marketing and described experiences of discrimination and provider bias. They believed peer voices and empowerment strategies could help address these barriers. These qualitative findings represent participants’ deliberations and do not show that any strategy increases uptake. The authors concluded that implementation should center Black women’s needs, peer advocacy, and the broader social and historical context rather than relying on generic PrEP messaging.

Key Takeaways

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Publications

Barriers/Facilitators

Science Frameworks

Implementation Science Frameworks

Outcomes

Community Partnerships

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