Improving HIV Prevention Services among Socioeconomically Disadvantaged Cis-gender Women

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Eliminating perinatal HIV in the U.S. is within reach. The overall rate of perinatal HIV infections in 2020 was 1:100,000, but there were disparities by race and ethnicity. For example, the rate of infections among Black/African American infants was 3.8:100,000, which is four and nearly 13 times the rates among Hispanic/Latino and White persons, respectively. To reduce the number of babies born with HIV, we must ensure pregnant women and their partners have access to HIV testing and PrEP. Opt-out HIV testing of the pregnant person is an effective evidenced-based strategy to prevent perinatal HIV transmission; however, this approach does not identify or address those at risk of HIV seroconversion during pregnancy. Ending the HIV epidemic may not be successfully achieved inn certain populations without the intentional engagement of the male partner during the pregnancy period. Male partner engagement benefits a wide range of outcomes related to maternal, child, and family wellbeing. U.S. guidelines recommend that partners of pregnant women undergo HIV testing when their status is unknown. However, this recommendation has not been implemented due to a lack of successful implementation research. Whereas the parent hybrid effectiveness-implementation trial (R01MH132146) addresses barriers to HIV testing and PrEP uptake among a non-pregnant population, this administrative supplement focuses on socioeconomically disadvantaged pregnant persons and their male partners. We aim to conduct a pilot mixed methods study to engage male partners in HIV prevention services during prenatal care. We hypothesize that the uptake of HIV prevention services (i.e., counseling, HIV testing, and PrEP) will increase with the engagement of the male partner (in-person or virtually) and the assessment of their HIV risk. This project will assess the perceived risk of HIV infection among the pregnant person and their male sexual partner with a validated survey. Next, we will offer male partners home-based HIV testing. Last, we will identify facilitators and barriers to testing uptake using in-depth interviews.