WITHDRAWN: Associations of Engagement in Preventive Sexual Health Services Utilization, and PrEP Interest Among Young Black Women

Background: Despite declines in rates of HIV among U.S. women, Black women experience disproportionate rates of HIV infection compared to other racial/ethnic women. HIV Pre-Exposure Prophylaxis (PrEP) is an effective intervention for HIV prevention, and African American women have a relatively high acceptability of PrEP. Therefore, offering PrEP and screening and testing for STI/HIV consistently can reduce HIV risk among this population. Despite what is known about PrEP acceptability among African American women, few studies have explored preventive sexual health services utilization (PSHSU) and PrEP interest among this group. This study examines the associations of PSHSU (STI/HIV testing, contraceptive use, routine checkup) and PrEP interest among young Black women (YBW) in the United States.

Methods: A sample of YBW completed a self-administered questionnaire assessing sexual risk and prevention behaviors, HIV/STI testing, and oral PrEP interest. Descriptive and bivariate analysis explored HIV risk and preventive sexual health-seeking behaviors. Binomial logistic regressions assessed the associations of PSHSU and PrEP interest among YBW, accounting for PrEP knowledge, perceived HIV risk, comfort level accessing HIV/STI services, and recent positive STI.

Results: On average, YBW (N=200) were 21.15 (SD=1.73) years old. Forty-four percent of YBW had some college education and over a third (34.5%) of YBW had a four-year college degree. Forty-three percent of YBW reported being single, and one-quarter of YBW reported being in a committed relationship. Most YBW (88%) were sexually experienced at the time of this study, and 75% of YBW reported their last vaginal sexual experience occurred within the past three months. Ninety percent of YBW engaged in preventive sexual health services. Fifty-two percent of YBW were aware of PrEP and its benefits prior to this study. The proportion of YBW who reported being interested in PrEP did not differ by preventive sexual health service utilization (x² (1, 209) = 0.71, p = .39). YBW, who received an HIV test within the past three to six months ([OR] 6.53, 95% CI: 1.25 – 34.13), had increased odds of PrEP interest compared to those who received an HIV test less than three months ago. YBW with active birth contraceptive use within the past year ([OR] 3.24, 95% CI: 1.06 – 9.91) had increased odds of PrEP interest compared to YBW without active birth contraceptive use within the past year.

Implications: Our findings suggest YBW engage in preventive sexual health services, including HIV/STI testing, reproductive health, and sexual health behavioral counseling. Given the disproportionate rate of HIV acquisition among Black women, it is important to consider venues outside of traditional HIV/STI testing facilities to engage this community. Particularly relevant to this sample is the need for colleges and student health centers to raise awareness of HIV PrEP. Understanding preventive sexual health-seeking behaviors of YBW allows researchers to tailor preventative sexual health programming and reduce the number of new STI/HIV cases among YBW. As we seek to eradicate HIV, we must address the racialized health disparities in HIV prevention.