{"doi":"10.1016/j.whi.2023.05.009","title":"Intention to Initiate HIV Pre-exposure Prophylaxis Among Cisgender Women in a High HIV Prevalence U.S. City","abstract":"OBJECTIVE: Our objective was to identify the individual, interpersonal, community, health-system, and structural factors that influence HIV pre-exposure prophylaxis (PrEP) initiation among cisgender women seeking sexual and reproductive health care in a high HIV prevalence community to inform future clinic-based PrEP interventions. METHODS: We collected anonymous, tablet-based questionnaires from a convenience sample of cisgender women in family planning and sexual health clinics in the District of Columbia. The survey used the lens of the socio-ecological model to measure individual, interpersonal, community, institutional, and structural factors surrounding intention to initiate PrEP. The survey queried demographics, behavioral exposure to HIV, perceived risk of HIV acquisition, a priori awareness of PrEP, intention to initiate PrEP, and factors influencing intention to initiate PrEP. RESULTS: A total of 1437 cisgender women completed the survey. By socio-ecological level, intention to initiate PrEP was associated with positive attitudes toward PrEP (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.13-2.15) and higher self-efficacy (OR, 1.32; 95% CI, 1.02-1.72) on the individual level, perceived future utilization of PrEP among peers and low fear of shame/stigma (OR, 1.65; 95% CI, 1.33-2.04) on the community level, and having discussed PrEP with a provider (OR. 2.39; 95% CI, 1.20-4.75) on the institutional level. CONCLUSION: Our findings highlight the importance of multilevel, clinic-based interventions for cisgender women, which promote sex-positive and preventive PrEP messaging, peer navigation to destigmatize PrEP, and education and support for women's health medical providers in the provision of PrEP services for cisgender women.","journal":"Women s Health Issues","year":2023,"id":339985,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":16,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9474,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":433887,"name":"Shawnika J. Hull","orcid":"0000-0002-3503-3289","position":1,"is_corresponding":false},{"id":751043,"name":"Chun-Chih Huang","orcid":"0000-0002-7461-4369","position":2,"is_corresponding":false},{"id":911437,"name":"Peggy Ye","orcid":"0000-0003-4665-9866","position":3,"is_corresponding":false},{"id":911438,"name":"Pamela S. Lotke","orcid":"0009-0001-0711-0486","position":4,"is_corresponding":false},{"id":1073981,"name":"Jason Beverley","orcid":"0000-0001-7593-8923","position":5,"is_corresponding":false},{"id":1073065,"name":"Patricia Moriarty","orcid":"0009-0006-8868-1366","position":6,"is_corresponding":false},{"id":1073982,"name":"Dhikshitha Balaji","orcid":"0000-0003-4207-4027","position":7,"is_corresponding":false},{"id":1074319,"name":"Allison Ward","orcid":null,"position":8,"is_corresponding":false},{"id":1074320,"name":"Jennifer Holiday","orcid":null,"position":9,"is_corresponding":false},{"id":911436,"name":"Ashley R. Brant","orcid":"0000-0001-8383-549X","position":10,"is_corresponding":false},{"id":1074321,"name":"Rick Elion","orcid":null,"position":11,"is_corresponding":false},{"id":1073983,"name":"Adam Visconti","orcid":"0000-0001-6257-1691","position":12,"is_corresponding":false},{"id":911942,"name":"Megan Coleman","orcid":null,"position":13,"is_corresponding":false},{"id":413926,"name":"Rachel K. Scott","orcid":"0000-0002-1519-9222","position":0,"is_corresponding":true}],"reference_count":70,"raw_metadata":null,"created_at":"2026-07-19T01:10:49.535464Z","pmid":"37479630","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}