Understanding Perceptions of HIV Risk, PrEP, and PrEP use among African American Women Attending an HBCU

修改后的项目总结/摘要部分 尽管在艾滋病毒预防和治疗方面取得了进展，但黑人/非裔美国妇女仍然 受艾滋病病毒感染的危害。虽然许多生物和行为因素塑造了妇女的艾滋病毒 个人层面的风险，健康的社会决定因素，包括贫困，生活在低收入社区， 心理健康状况不佳，以及缺乏对包括暴露前预防（PrEP）在内的关键艾滋病毒预防服务的了解和获得机会，可能会导致这种不成比例的负担。非裔美国妇女不仅面临更大的风险，而且在获得PrEP方面也不公平，特别是那些生活在美国南部低收入社区的妇女。此外，很少有非洲裔美国妇女，包括HBCU的学生（其中许多人在低收入社区长大），知道PrEP.虽然PrEP在预防艾滋病毒传播方面非常有效，但在美国，只有10%的妇女可以受益于PrEP在2019年被开了处方（CDC，2022）。增加PrEP的获得对年轻女性（35岁以下）尤为重要，她们占所有女性艾滋病毒感染者的41%。由于HBCU主要为年轻女性服务，（2021年，HBCU的学生中有64%是女性），而且他们的许多学生来自低收入社区，HBCU是接触PrEP服务不足的重要人群的理想环境。为了提高HBCU女性的PrEP利用率，需要进行更多的研究，以了解她们对PrEP的低使用率。关于黑人大学女性使用PrEP的数据有限。此外，需要更多的非洲裔美国人艾滋病毒预防研究人员，因为他们可能更熟悉影响黑人社区的因素，因为他们有共同的文化和生活经历。因此，拟议项目的主要目标是参与和指导来自HBCU的非裔美国女性学者进行研究，以评估黑人大学女性对PrEP的知识和态度，对艾滋病毒风险的看法，艾滋病毒检测行为，以及PrEP摄取的可能性。为了实现这一主要目标，拟议的项目还将为这些学者的PrEP交付研究计划奠定基础，建立在现有的基于社区的PrEP交付计划（IFE 4 Her）的基础上。为了适应这一计划，我们将进行形成性研究，为HBCU女性量身定制基于同行的PrEP信息活动。这些目标将通过两个具体目标实现：1）建立和支持一支高技能的非洲裔美国人艾滋病毒预防研究人员队伍，以解决非洲裔美国人社区在使用预防战略（包括PrEP）方面的研究差距，重点是HBCU。这一目标将通过一系列结构化的培训和正在进行的咨询和辅导由CSCFAR和相关的教师，NCCU RCMI的长期合作伙伴提供实现。2）通过进行混合方法（焦点小组，关键线人访谈和调查）定制研究，以了解参加HBCU的非裔美国妇女的PrEP知识，态度，消息偏好和交付需求，为HBCU妇女调整IFE 4 Her基于同伴的PrEP沟通策略。这项研究将为非常有前途的RCMI调查人员提供一系列研究，以制定HBCU适当的干预措施，以降低参加HBCU的妇女的艾滋病毒风险。

Modified Project Summery/Abstract Section Despite advancements in HIV prevention and treatment, Black/African American women remain disproportionally affected by HIV infection. While many biological and behavioral factors shape women’s HIV risk at the individual level, social determinants of health including poverty, living in low-income communities, poor mental health, and lack of knowledge of and access to critical HIV prevention services including preexposure prophylaxis (PrEP) may drive this disproportionate burden. African American women are not only at increased risk but also have inequitable access to PrEP, particularly those living in low-income neighborhoods in the US South. Furthermore, few African American women, including students at HBCUs (many of whom grew up in low-income communities), are aware of PrEP. Although PrEP is highly effective in preventing the spread of HIV, only 10% of women in the US who could benefit from PrEP were prescribed it in 2019 (CDC, 2022). Increasing PrEP access is especially important for young women (under age 35), who experience 41% of all HIV infections among women. As HBCUs serve predominantly young women (64% of HBCU students were female in 2021) and many of their students come from low-income communities, HBCUs are an ideal context to reach an important population underserved by PrEP. To improve PrEP utilization among HBCU women, more research is needed to understand their low use of PrEP. Limited data exist about Black college women’s use of PrEP. Additionally, more African American HIV prevention researchers are needed because they may be more familiar with factors impacting Black communities due to their shared culture and life experiences. Thus, the primary goal of the proposed project is to engage and mentor African American female scholars from an HBCU in research to assess Black college women’s knowledge of and attitudes toward PrEP, perception of HIV risk, HIV testing behaviors, and likelihood of PrEP uptake. In service of this primary aim, the proposed project will also lay the foundation for a program of PrEP delivery research for these scholars, building on an existing community-based PrEP delivery program (IFE4Her). To adapt this program, we will conduct formative research to tailor a peer-based PrEP messaging campaign for HBCU women. These goals will be achieved through 2 Specific Aims: 1) To create and support a cadre of highly skilled African American HIV prevention researchers to address research gaps in the use of prevention strategies including PrEP, in African American communities, focusing on HBCUs. This aim will be achieved through a series of structured trainings and ongoing consultations and mentorship provided by UNC CFAR and associated faculty, longtime partners of the NCCU RCMI. 2)To adapt the IFE4Her peer-based PrEP communication strategy for HBCU women by conducting a mixed-methods (focus groups, key informant interviews, and surveys) tailoring study to understand PrEP knowledge, attitudes, messaging preferences, and delivery needs of African American women attending a HBCU. This study will catapult a body of research for highly promising RCMI investigators to develop HBCU-appropriate interventions to reduce HIV risk among women attending HBCUs.