Women View PrEP Services as a Natural Extension of OB/GYN Care

As experts in sexual and reproductive health, OB/GYNs should offer pre-exposure prophylaxis (PrEP) services for human immunodeficiency virus (HIV) as a natural extension of care they already provide, according to the women they treat. Researchers published the finding online in Frontiers in Reproductive Health.

“In this study of women attending OB/GYN clinics at an urban medical center, we found that women’s comfort discussing PrEP with their OB/GYN was intertwined with the trust in their clinician as well as the stigma they confront about their sexuality, particularly sexual behavior that puts them at risk for HIV infection,” wrote Antoinette A. Danvers, MD, of the Montefiore Medical Center Department of Obstetrics and Gynecology and Women’s Health in the Bronx, New York, and coauthors.

The study included 30 women from an ambulatory OB/GYN clinic at Montefiore Medical Center. Among them, 10 were seeking care for family planning, 10 for prenatal care, and 10 for a sexually transmitted infection. A PrEP screening tool indicated 70% of participants had risk factors for HIV acquisition and would benefit from PrEP discussion.

Semi-structured interviews with the women revealed three themes. First, participants consistently considered OB/GYNs as experts in sexual health care and PrEP. Second, the women were concerned about PrEP stigma and encountering judgement about sexual promiscuity if they expressed a need for PrEP.

“Their OB/GYN may be the only person they can be completely honest with about their sexual behavior,” researchers wrote. “Yet, there was the lingering worry that even their OB/GYN, the safe harbor for their sexual concerns, may judge them.”

Third, trust in their OB/GYN, when present, offset stigma as a barrier and was a facilitator for considering PrEP.

“Multiple participants suggested that initial counseling on PrEP should be offered universally to patients, regardless of sexual history or personal risk factors,” researchers advised. “In this way, the conversation is framed as a general effort to increase patient awareness and access to information rather than ‘targeted’ counseling to women who are ‘judged’ to be at risk.”

Reference:
Danvers AA, Chew Murphy E, Avila K, et al. Women trust their OBGYNs to provide preexposure prophylaxis: an opportunity for HIV prevention. Front Reprod Health. Published online March 15, 2022. doi:10.3389/frph.2022.832287