IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v275y2021ics0277953621001416.html
   My bibliography  Save this article

“PrEP just isn't my priority”: Adherence challenges among women who inject drugs participating in a pre-exposure prophylaxis (PrEP) demonstration project in Philadelphia, PA USA

Author

Listed:
  • Felsher, Marisa
  • Ziegler, Eliza
  • Amico, K. Rivet
  • Carrico, Adam
  • Coleman, Jennie
  • Roth, Alexis M.

Abstract

Pre-exposure prophylaxis (PrEP) has the ability to curb HIV transmission among women if they are highly adherent (e.g. 6/7 weekly doses). In a recent PrEP demonstration project with 95 women who inject drugs (WWID) in Philadelphia, PA, USA, PrEP uptake was high but adherence was low. This qualitative study draws upon the Behavioral Model for Vulnerable Populations (BMVP) to describe how the context of 23 WWID's lives challenged PrEP adherence using narrative data from in-depth interviews. Content analysis suggests that women's need to organize their day around predisposing survival needs made it difficult to prioritize PrEP. Adherence was further challenged by dis-enabling structural forces such as entry into institutions that do not provide PrEP (e.g., drug treatment and correctional facilities) and medication diversion to illicit marketplaces. Overtime, women's perceived need for PrEP was dynamic: in periods they characterized as risky, women considered PrEP highly beneficial and described enhanced motivation to adhere. In periods of low perceived risk, women were less committed to continuing daily PrEP in the context of their competing survival needs. In sum, WWID faced challenges to PrEP adherence that correspond to all of the BMVP domains. To optimize PrEP for WWID, multi-level programs are needed that address the determinants that both increase HIV susceptibility and undermine adherence.

Suggested Citation

  • Felsher, Marisa & Ziegler, Eliza & Amico, K. Rivet & Carrico, Adam & Coleman, Jennie & Roth, Alexis M., 2021. "“PrEP just isn't my priority”: Adherence challenges among women who inject drugs participating in a pre-exposure prophylaxis (PrEP) demonstration project in Philadelphia, PA USA," Social Science & Medicine, Elsevier, vol. 275(C).
    • Handle: RePEc:eee:socmed:v:275:y:2021:i:c:s0277953621001416
    DOI: 10.1016/j.socscimed.2021.113809
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953621001416
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2021.113809?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Shannon, Kate & Kerr, Thomas & Allinott, Shari & Chettiar, Jill & Shoveller, Jean & Tyndall, Mark W., 2008. "Social and structural violence and power relations in mitigating HIV risk of drug-using women in survival sex work," Social Science & Medicine, Elsevier, vol. 66(4), pages 911-921, February.
    2. Calabrese, S.K. & Underhill, K., 2015. "How stigma surrounding the use of HIV preexposure prophylaxis undermines prevention and pleasure: A call to destigmatize "truvada whores"," American Journal of Public Health, American Public Health Association, vol. 105(10), pages 1960-1964.
    3. Rao, Vijayendra & Gupta, Indrani & Lokshin, Michael & Jana, Smarajit, 2003. "Sex workers and the cost of safe sex: the compensating differential for condom use among Calcutta prostitutes," Journal of Development Economics, Elsevier, vol. 71(2), pages 585-603, August.
    4. Hansen, Helena & Bourgois, Philippe & Drucker, Ernest, 2014. "Pathologizing poverty: New forms of diagnosis, disability, and structural stigma under welfare reform," Social Science & Medicine, Elsevier, vol. 103(C), pages 76-83.
    5. Surratt, H.L. & Kurtz, S.P. & Cicero, T.J. & O'Grady, C. & Levi-Minzi, M.A., 2013. "Antiretroviral medication diversion among HIV-positive substance abusers in South Florida," American Journal of Public Health, American Public Health Association, vol. 103(6), pages 1026-1028.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. de Walque, Damien, 2007. "How does the impact of an HIV/AIDS information campaign vary with educational attainment? Evidence from rural Uganda," Journal of Development Economics, Elsevier, vol. 84(2), pages 686-714, November.
    2. Hiroyuki Yamada & Yuki Kanayama & Kanako Yoshikawa & Kyaw Wai Aung, 2023. "Risk attitude, risky behaviour and price determination in the sex market: A case study of Yangon, Myanmar," Pacific Economic Review, Wiley Blackwell, vol. 28(5), pages 665-691, December.
    3. Luke, Nancy, 2006. "Exchange and Condom Use in Informal Sexual Relationships in Urban Kenya," Economic Development and Cultural Change, University of Chicago Press, vol. 54(2), pages 319-348, January.
    4. Wong, Sandy, 2016. "Geographies of medicalized welfare: Spatial analysis of supplemental security income in the U.S., 2000–2010," Social Science & Medicine, Elsevier, vol. 160(C), pages 9-19.
    5. Spagnolo, Giancarlo & Berlin, Maria & Immordino, Giovanni & Russo, Francesco, 2020. "Paper Withdrawn," CEPR Discussion Papers 15188, C.E.P.R. Discussion Papers.
    6. Wilson Nicholas, 2019. "The World’s Oldest Profession? Employment-Age Profiles from the Transactional Sex Market," IZA Journal of Labor Policy, Sciendo & Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 9(1), pages 1-17, June.
    7. Anson Au, 2023. "Reassessing the econometric measurement of inequality and poverty: toward a cost-of-living approach," Palgrave Communications, Palgrave Macmillan, vol. 10(1), pages 1-10, December.
    8. Peter G. Moffatt & Simon A. Peters, 2004. "Pricing Personal Services: An Empirical Study of Earnings in the UK Prostitution Industry," Scottish Journal of Political Economy, Scottish Economic Society, vol. 51(5), pages 675-690, November.
    9. Paul J. Gertler & Manisha Shah, 2011. "Sex Work and Infection: What's Law Enforcement Got to Do with It?," Journal of Law and Economics, University of Chicago Press, vol. 54(4), pages 811-840.
    10. Whittle, Henry J. & Palar, Kartika & Hufstedler, Lee Lemus & Seligman, Hilary K. & Frongillo, Edward A. & Weiser, Sheri D., 2015. "Food insecurity, chronic illness, and gentrification in the San Francisco Bay Area: An example of structural violence in United States public policy," Social Science & Medicine, Elsevier, vol. 143(C), pages 154-161.
    11. Shirley J Semple & Jamila K Stockman & Eileen V Pitpitan & Steffanie A Strathdee & Claudia V Chavarin & Doroteo V Mendoza & Gregory A Aarons & Thomas L Patterson, 2015. "Prevalence and Correlates of Client-Perpetrated Violence against Female Sex Workers in 13 Mexican Cities," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-15, November.
    12. Yang, Lawrence H. & Chen, Fang-pei & Sia, Kathleen Janel & Lam, Jonathan & Lam, Katherine & Ngo, Hong & Lee, Sing & Kleinman, Arthur & Good, Byron, 2014. "“What matters most:” A cultural mechanism moderating structural vulnerability and moral experience of mental illness stigma," Social Science & Medicine, Elsevier, vol. 103(C), pages 84-93.
    13. Abel Brodeur & Warn N Lekfuangfu & Yanos Zylberberg, 2018. "War, Migration and the Origins of the Thai Sex Industry," Journal of the European Economic Association, European Economic Association, vol. 16(5), pages 1540-1576.
    14. Alexander Muravyev & Oleksandr Talavera, 2018. "Unsafe Sex in the City: Risk Pricing in the London Area," Scottish Journal of Political Economy, Scottish Economic Society, vol. 65(5), pages 528-549, November.
    15. Jonathan Robinson & Ethan Yeh, 2011. "Transactional Sex as a Response to Risk in Western Kenya," American Economic Journal: Applied Economics, American Economic Association, vol. 3(1), pages 35-64, January.
    16. Felicity Thomas & Lorraine Hansford & Joseph Ford & Katrina Wyatt & Rosemarie McCabe & Richard Byng, 2018. "Moral narratives and mental health: rethinking understandings of distress and healthcare support in contexts of austerity and welfare reform," Palgrave Communications, Palgrave Macmillan, vol. 4(1), pages 1-8, December.
    17. Salhi, Bisan A., 2020. "Who are Clive's friends? Latent sociality in the emergency department," Social Science & Medicine, Elsevier, vol. 245(C).
    18. He, Guojun & Peng, Wenwei, 2022. "Guns and roses: Police complicity in organized prostitution," Journal of Public Economics, Elsevier, vol. 207(C).
    19. Niklas Jakobsson & Andreas Kotsadam, 2013. "The law and economics of international sex slavery: prostitution laws and trafficking for sexual exploitation," European Journal of Law and Economics, Springer, vol. 35(1), pages 87-107, February.
    20. Rafael Muñoz de Bustillo & Enrique Fernández-Macías & José-Ignacio Antón & Fernando Esteve, 2011. "Measuring More than Money," Books, Edward Elgar Publishing, number 14072.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:275:y:2021:i:c:s0277953621001416. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.