Exploring Pre-Exposure Prophylaxis (PrEP) modality preferences among Black cisgender women attending family planning clinics in Chicago

Background: Despite Pre-exposure prophylaxis (PrEP) demonstrated effectiveness, Black cisgender women continue to be at an elevated risk for HIV acquisition and uptake of daily oral PrEP is low in this population in the US. As advancements in PrEP delivery options continue, it is important to understand womens acceptability of these additional options, specifically Black cisgender women, in order to inform uptake and adherence among this population at increased need of HIV prevention options. Setting: A cross-sectional survey among Black cisgender women ages 13-45 (inclusive) attending health clinics in Chicago, IL, prior to the approval of CAB-LA. Methods: Descriptive statistics were used to describe the sample and bivariate analysis was used to detect differences between categorical and outcome variables using chi-square test. Responses to open-ended questions were thematically coded to explore Black cisgender womens attitudes and preferences between the three methods of PrEP delivery including: vaginal ring, long-acting injectable, and a combined method that would prevent both pregnancy and HIV. Results: In total, 211 cisgender women and adolescents responded to the survey. Both injections and combination pills were popular among participants, with 64.5% and 67.3% expressing interest in these forms of PrEP, respectively. The least popular method was the vaginal ring option, with 75.4% of respondents indicating that they would not consider using this modality. Overall, responses were not statistically different between the two surveys administered (Chi square p-values for injection PrEP method 0.66, combination PrEP method 0.93, and ring PrEP method 0.66) suggesting that the popularity of each method was not dependent on clinic location or age of participants. Conclusion: This research provides important insights into the preferences and attitudes of different PrEP modalities among Black cisgender women. As different modalities continue to be approved for use among cisgender women, more research is needed to investigate the acceptability and preferences of these different modalities in order to improve uptake and adherence among this population. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This work was supported by funding received from the Society of Family Planning Research Fund (#SFPFR11-II5-2) and The University of Chicago Womens Board. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The IRB of University of Chicago and Ann & Robert H. Lurie Children's Hospital of Chicago gave ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors