Pre-Exposure Prophylaxis (PrEP) Modality Preferences Among Women who Inject Drugs in Philadelphia, Pennsylvania

Monday, June 7th 2021

11:30 AM - 1:00 PM

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Pre-exposure prophylaxis (PrEP) can prevent HIV transmission among women who inject drugs (WWID) when used as directed, but medication adherence remains low in this population. New PrEP modalities show great potential to improve PrEP outcomes among WWID, including women who face barriers to care due to social or racial inequities. This mixed-methods study explored WWID’s preference and willingness to use four different PrEP modalities (daily oral pills, long-acting injectable PrEP, vaginal ring, vaginal gel) and the personal characteristics or circumstances that influence PrEP modality choice by integrating survey questionnaires with qualitative interviews among WWID in Philadelphia. 95 WWID participating in a PrEP demonstration project participated in survey questionnaires; 12 participated in in-depth interviews. Most participants ranked daily oral PrEP as their #1 preferred modality (55.8%), followed by long-acting injectable PrEP (35.8%), vaginal ring (7.4%), and vaginal gel (1.1%). Narratives highlight forgetfulness and instability as factors that challenged adherence to daily oral pills, leading some participants to prefer long-acting injectable PrEP for relative ease of use. Aversion to shots emerged as a reason some participants preferred daily oral pills despite stated benefits of long-acting injectable PrEP. As new PrEP variations become available to consumers in the United States, our findings suggest offering WWID a variety of modalities may improve PrEP outcomes.


  1. Describe disparities in HIV transmission and barriers to accessing PrEP among women who inject drugs, with emphasis on social and racial inequities in this population
  2. Describe novel PrEP modalities under development (long-acting injectable PrEP, vaginal ring, and vaginal gel)
  3. Report results from mixed-methods study exploring PrEP modality preferences among women who inject drugs


Kerry Miley

Drexel University

Kerry Miley, MPH, is an Urban Health Research Fellow working alongside the Health Equity Advancement Lab (HEAL) at Drexel University’s Dornsife School of Public Health, where she has contributed to a number of studies exploring novel interventions for preventing opioid overdose and HIV transmission.

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Spotlight On

Karam Mounzer, MD

Dr. Mounzer identified two major gaps in the care of patients with HIV/hepatitis C (HCV) co-infection, and the complexity of multidrug-resistant HIV treatment. He is involved with many clinical trials focusing on drug development and better understanding of HIV immunopathogenesis with the Wistar Institute. He is involved in teaching and mentoring.

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Dr. Karam Mounzer

Dr. Mario Cruz

Dr. Mario CruzDr. Cruz is a board certified pediatrician who serves as the Medical Director for our Pediatrics and Adolescent Health Center. He has presented and/or published in the fields of community violence and domestic violence prevention, quality improvement, behavioral health, curriculum development and mentorship. In 2019 he received the Greater Philadelphia Social Innovation Award for Innovations in Healthcare.

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