1. A Pilot Randomized Control Trial of the Motivational Interviewing to Increase PrEP Uptake Intervention Among Black Women in the United States.
- Author
-
Dale, Sannisha K., Petrulla, Victoria, and Wright, Ian A.
- Subjects
- *
EDUCATION of African Americans , *MOTIVATIONAL interviewing , *HEALTH literacy , *HEALTH services accessibility , *RESEARCH funding , *T-test (Statistics) , *MEDICAL case management , *EDUCATIONAL outcomes , *STATISTICAL sampling , *PILOT projects , *QUESTIONNAIRES , *PSYCHOEDUCATION , *RANDOMIZED controlled trials , *PRE-exposure prophylaxis , *ODDS ratio , *MOTIVATION (Psychology) , *TRANSPORTATION , *PRE-tests & post-tests , *CISGENDER people , *MEDICAL records , *ACQUISITION of data , *WOMEN'S health , *CONFIDENCE intervals , *COMPARATIVE studies , *MEDICAL mistrust , *DATA analysis software , *SEXUAL health - Abstract
Despite the disproportional impact of HIV, Black individuals are benefiting the least from pre-exposure prophylaxis (PrEP). Motivational interviewing (MI) for PrEP uptake (MI-PrEP) is a two-session culturally tailored intervention incorporating MI strategies to improve PrEP motivation and uptake among cisgender Black women. A pilot randomized control trial was conducted in the Southeastern United States, and 41 women were randomized to MI-PrEP (session 1 with PrEP psychoeducation and MI and session 2 with MI and light case management) or enhanced treatment as usual (ETAU; two sessions of PrEP psychoeducation [videos explaining PrEP]). Women completed one follow-up assessment (1 month after visit 2). Measures captured primary (motivation [via contemplation and readiness ruler] and PrEP uptake via medical records) and secondary outcomes (e.g., PrEP knowledge, barriers to PrEP, and speaking to a provider about PrEP). Difference-in-differences analyses comparing MI-PrEP with ETAU as well as t-tests for within-group changes over time were conducted. Women who completed MI-PrEP (90.5% retained) compared with ETAU (100% retained) had a significantly higher likelihood of speaking to a provider about PrEP (OR = 4.42e7, CI [8.55e6, 2.29e8], DiD = 17.60, se = 0.84, p < 0.001). Within the MI-PrEP group, women had significant increases in PrEP prescription, knowledge, and motivation/contemplation, and significant decreases in financial resources as a PrEP barrier and medical mistrust (MMT). ETAU had within-group increases in PrEP prescription and speaking to a provider, no changes in motivation and MMT, and increases in specific barriers to care (e.g., transportation). MI-PrEP shows promise, and a large-scale study may be beneficial to further assess efficacy and examine implementation. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF