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Abstract <p>People under community supervision who use drugs face elevated HIV risk. This randomized controlled trial used a mixed-methods approach to examine PrEP acceptance among community-supervised men who use drugs and their female partners. The study evaluated PrEP willingness among participants (<i>N</i> = 394) randomized to either PACT (5-session couples’ HIV intervention) or control (1-session HIV counseling). Qualitative interviews with 20 couples (<i>n</i> = 40) explored PrEP attitudes. The PACT group showed significantly higher intentions to use condoms with PrEP compared to controls (64% vs. 53%, <i>p</i> = 0.03). Female partners in the PACT intervention demonstrated stronger PrEP use intentions than females in the control (aOR = 2.85, <i>p</i> = 0.02). Qualitative findings revealed five key factors affecting PrEP acceptance: (1) partner infidelity concerns, (2) substance use and decision-making, (3) HIV acquisition fears, (4) low-risk perception despite objective risk factors, and (5) medical mistrust. Gender influences PrEP acceptance among criminal legal-involved couples. Effective interventions should address gender differences, risk perception disparities, and medical mistrust.</p> Trial registration <p>ClinicalTrials.gov NCT01690494 registered September 19, 2012.</p>

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“Why not take that pill?”: A Mixed-Methods Study of Gender, Risk Perception, and PrEP Uptake Among Drug-Involved Heterosexual Couples Under Community Supervision

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月29日

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  • Dawn Goddard-Eckrich,
  • Srishti Meera Sardana,
  • Brandy F. Henry,
  • Dget Lynn Downey,
  • Louisa Gilbert,
  • Kristi L. Stringer,
  • Mingway Chang,
  • Elwin Wu,
  • Brittany V. Thomas,
  • Leslie-Ann Bolden,
  • Nell Mckenna,
  • Bilal Tinvar Abbas,
  • Caroline Prichard,
  • Blerta Baholli,
  • Nabila El-Bassel,
  • Timothy Hunt

摘要

Abstract

People under community supervision who use drugs face elevated HIV risk. This randomized controlled trial used a mixed-methods approach to examine PrEP acceptance among community-supervised men who use drugs and their female partners. The study evaluated PrEP willingness among participants (N = 394) randomized to either PACT (5-session couples’ HIV intervention) or control (1-session HIV counseling). Qualitative interviews with 20 couples (n = 40) explored PrEP attitudes. The PACT group showed significantly higher intentions to use condoms with PrEP compared to controls (64% vs. 53%, p = 0.03). Female partners in the PACT intervention demonstrated stronger PrEP use intentions than females in the control (aOR = 2.85, p = 0.02). Qualitative findings revealed five key factors affecting PrEP acceptance: (1) partner infidelity concerns, (2) substance use and decision-making, (3) HIV acquisition fears, (4) low-risk perception despite objective risk factors, and (5) medical mistrust. Gender influences PrEP acceptance among criminal legal-involved couples. Effective interventions should address gender differences, risk perception disparities, and medical mistrust.

Trial registration

ClinicalTrials.gov NCT01690494 registered September 19, 2012.