HIV risk perception and PrEP attitudes, knowledge and preferences among women presenting for abortion care: A cross-sectional descriptive study
Awarded 2018
Complex Family Planning Fellowship Research
Jessika Ralph, MD
Northwestern University

Our research is focused on improving women’s access to HIV prevention methods. Human immunodeficiency virus, or HIV, is a virus that attacks the immune system, and if untreated, causes autoimmune deficiency syndrome, or AIDS. There is no cure, but with proper treatment, HIV can be controlled. HIV is spread from one person to another when one person comes into contact with infected body fluids. This means that for many women, they become infected when they have sex with a man that has HIV.
There is a new method of HIV prevention, called pre-exposure prophylaxis, or PrEP. PrEP is the use of medications to prevent HIV infection by people who do not have HIV. PrEP works very well, but currently, not many women use it – only about 1% of women at high risk of becoming infected with HIV use PrEP.
Many women that need abortion care are also women that have many risk factors for HIV infection. For this reason, figuring out how to improve access to PrEP for these women is important.
Our study aimed to describe the knowledge and attitudes of women seeking abortion care regarding HIV and PrEP. We invited English-speaking women at least 18 years old and between 5w0d and 23w6d gestation to participate in an anonymous, electronic survey. Women with known HIV infection were excluded. We asked participants questions about many topics, including where they would want to get information about PrEP, where they would want to get the medication, and who they would want to take care of them. We also asked about their health and behaviors to learn about whether they were at high risk of becoming infected with HIV.
198 women took our survey. 69% of them were Black and 18% were Hispanic. The majority had both health insurance and at least some education after graduating from high school. Only 16% of participants had ever heard of PrEP. One-third of the participants had enough risk factors for HIV infection to be a candidate for PrEP medication.  Almost the same number of participants would be interested in starting PrEP to prevent HIV infection. The majority of participants would prefer to receive PrEP care from their primary care provider, and would not want to get this care at an abortion clinic. Participants with indications for PrEP were more likely to estimate their risk of HIV infection as elevated and worried about infection more often, but were no more likely to be interested in starting PrEP than participants without indications for PrEP.
From these responses, we made the following conclusions: 1) Many women seeking abortion have risk factors for HIV infection. 2) Knowledge of PrEP as a method of HIV prevention among women seeking abortion is low, but attitudes towards its use are positive. 3) Women would prefer to receive PrEP care from places other than an abortion clinic.