Danielle P. Clement, MSN'18, and Associate Professors Kara McGee and Kathryn Trotter co-wrote "PrEP for women: An update for healthcare providers" for "Women's Healthcare." 

Introduction

Women account for almost 20% of all new diagnoses of human immunodeficiency virus (HIV) in the United States, yet their utilization of pre-exposure prophylaxis (PrEP) to prevent HIV infection is highly underutilized. Significant racial, social, and cultural factors further marginalize those who are at increased risk. Women’s healthcare providers should screen for HIV risk and offer PrEP during routine clinical encounters. 

Although human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) is a highly effective method of HIV prevention, it is largely underutilized by women, who account for almost 20% of all new HIV diagnoses in the United States.^1,2 Awareness and utilization of PrEP is increasing among men who have sex with men (MSM) but continues to remain low among women, particularly among those at increased risk. The latter group includes Black women and women living in geographies with a high concentration of HIV such as the Southern region of the United States, which accounts for 52% of new HIV diagnoses.³ Trends in HIV infections further highlight the significant racial disparities that persist for Black women, whose rate of HIV acquisition is 16 times that of White women and 5 times that of Hispanic women.⁴ PrEP use among women has the potential to reduce new HIV infections by 61% (with ≥ 75% adherence), yet less than 10% of men and women who are “behaviorally indicated for PrEP” are utilizing this important prevention tool.³  

There are many known political, cultural, and institutional barriers that increase girls’ and young women’s HIV risk, including poverty, gender inequality, sexual and partner violence, and inadequate access to educational opportunities.⁵ PrEP has the potential for high acceptability and uptake among women; however, access to sexual health services and knowledge of HIV prevention tools are often limited, particularly in areas where it is most needed. As barriers to access have been exacerbated by current political pressures, economic cutbacks, and health disparities intensified by the Covid-19 pandemic, connecting our most vulnerable populations with the care and prevention tools they need to live healthy lives is critical.