Assessing Subjective Norms Towards HIV As Barriers and Facilitators for Intent to Share Information about PrEP

Background and Purpose:

Women, especially women of color, are at an increased risk of contracting HIV and are more likely to suffer from negative health outcomes related to social determinants of health and marginalization. PrEP, or Pre-Exposure Prophylaxis, has been identified as a reliable tool to reduce the spread of HIV among high-risk priority populations. When used properly, PrEP has the potential to serve as an efficacious preventive option; still, a significant percentage of women of color are unaware of PrEP as a daily preclusion regimen. Largely, efforts have been sluggish for increasing awareness and access to PrEP among cisgender (non-transgender women or “cis”) and transgender (“trans”) women of color, that are at an increased risk for HIV-infection. Service providers including social workers are vital for in preventing HIV-infection among women of color. This study aimed to increase knowledge and awareness about PrEP among women of color through “Be PrEPared,” an online health education intervention. Primary objectives: (1) assess subjective norms towards HIV; (2) increase knowledge and intent to share information about PrEP. Secondary objective: assess internal consistence of intent to use PrEP questionnaire. This session will report results from the service provider data.

Methods:

Participants were recruited through various health communication strategies to complete “Be PrEPared.” Afterwards, participants completed the online evaluation through Psychdata. Evaluation variables corresponded with the online intervention and included HIV knowledge, attitudes towards condoms, self-efficacy for sexual health practices, and stereotypes towards HIV. We also created and implemented the intent to use PrEP scale to assess internal consistency for subjective norms and other Theory of Reasoned Acton constructs. Paired sample t-test was used to analyze pre/post data along with Cronbach’s alpha to determine scale reliability.

Results:

A total 133 service providers completed “Be PrEPared” and over 90% intend to share information about PrEP within various timepoints through one year post-intervention. A significant increase in favorable attitudes towards condoms post-intervention was reported, including effective methods for preventing HIV (t=3.209 p=.002) and suggesting condom use with partner (t=6.349 p<.001). Self-efficacy for getting an HIV test (t=6.112 p<001) and negotiation safer sex practices (t=7.933 p<001) also increased. Participants also reported they were more likely to use PrEP post-intervention if it were available (t=11.416 p<001) and affordable (t=17.072 p<001). Finally, internal consistency was indicated on the intent to use PrEP questionnaire as determined by a Cronbach’s alpha of 0.878. Scale items to assess subjective norms related to approval for taking PrEP among those important to the participant also showed internal consistency with a Cronbach’s alpha of 0.867.

Conclusion:

PrEP has the potential to reduce HIV transmission among cis and trans women of color. As such, service providers, including social workers, can assist with decreasing HIV-infection by sharing information about PrEP. Barriers and facilitators for sharing information about PrEP, such as attitudes towards condoms, self-efficacy for performing sexual health practices, and subjective norms for service providers must be addressed as the first line of HIV-prevention. Service providers must also be able to determine intent to use PrEP to tailor their outreach efforts.