Preexposure prophylaxis (PrEP) for HIV prevention uptake remains low among Black cisgender women in the United States, despite their disproportionate HIV burden. This study aimed to examine factors associated with Black women’s comfort discussing PrEP with healthcare providers and its link to their interest in PrEP use. A cross-sectional survey was conducted with a national sample of 315 Black cisgender women. Descriptive statistics and logistic regression models were utilized for data analysis. The results showed that 79% of Black women felt comfortable discussing PrEP with their healthcare provider. Age, recent healthcare provider visit, interest in PrEP, and positive social norms were associated with increased odds of comfort in discussing PrEP, while anticipated PrEP disapproval and stigma were associated with decreased odds. Older age was related to greater comfort, potentially due to increased familiarity and self-efficacy in discussing sexual health. Recent healthcare utilization indicated positive provider relationships, facilitating discussions about sexual health. Anticipating support from social networks positively influenced comfort levels. Conversely, PrEP-related stigma and anticipated disapproval were barriers to comfort. These findings highlight the importance of provider–patient communication and social support in facilitating PrEP engagement among Black cisgender women. Interventions should consider age-appropriate strategies and address structural and provider biases to improve PrEP discussions and promote HIV prevention.

This study sought to examine the role of providers as health discussants (HD) on interest in preexposure prophylaxis for HIV prevention in a national sample of adult Black cisgender women (N = 315). Health discussant networks, a type of social network, may be influential in HIV prevention efforts. These networks, often composed of individuals’ families, have improved health utilization outcomes in other disciplines. However, health discussants in HIV prevention are understudied, especially when considering providers as network members. We conducted a cross-sectional online survey and collected socio-demographic information, sexual history, HIV concerns, PrEP attitudes, healthcare utilization, mistrust, social support, and HD information. We used descriptive statistics and logistic regression to analyze data. Associations between PrEP interest and variables were examined. We found that older, partnered, who had recent healthcare visits or health insurance were more likely to involve healthcare providers as discussants. Anticipated PrEP stigma decreased provider involvement. Among participants listing providers as discussants, there was a greater likelihood of interest in using PrEP. Our findings indicate that healthcare provider support and social factors are crucial in promoting PrEP engagement among Black women. Integrating social dynamics and positive provider-patient interactions is essential for successful PrEP implementation.

Background: In the US, seventy percent of drug-related deaths are attributed to opioids. In response to the ongoing opioid crisis, New Jersey's (NJ) Medicaid program implemented the MATrx model to increase treatment access for Medicaid participants with opioid use disorder (OUD). The model's goals include increasing the number of office-based treatment providers, enhancing Medicaid reimbursement for certain treatment services, and elimination of prior authorizations for OUD medications.Objectives: To explore office-based addiction treatment providers' experiences delivering care in the context of statewide policy changes and their perspectives on treatment access changes and remaining barriers.Methods: This qualitative study used purposive sampling to recruit office-based New Jersey medications for opioid use disorder (MOUD) providers . Twenty-two providers (11 females, 11 males) discussed treatment experiences since the policy changes in 2019, including evaluations of the current state of OUD care in New Jersey and perceived outcomes of the MATrx model policy changes.Results: Providers reported the MOUD climate in NJ improved as Medicaid implemented policies intended to reduce barriers to care and increase treatment access. Elimination of prior authorizations was noted as important, as it reduced provider burden and allowed greater focus on care delivery. However, barriers remained, including stigma, pharmacy supply issues, and difficulty obtaining injectable or non-generic medication formulations.Conclusion: NJ policies may have improved access to care for Medicaid beneficiaries by reducing barriers to care and supporting providers in prescribing MOUD. Yet, stigma and lack of psychosocial supports still need to be addressed to further improve access and care quality.

Introduction: To address suboptimal HIV pre‐exposure prophylaxis (PrEP) uptake among Black women, we designed PrEP4Her, a multi‐phase, multi‐component implementation strategy aimed to increase PrEP prescriptions among women receiving routine health services at a university‐affiliated gynaecology (GYN) clinic located in the Southeastern United States. Methods: Informed by intervention mapping, PrEP4Her, a hybrid type 3 trial, was piloted over 8 months, January 2024–August 2024, and the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE‐AIM) conceptual framework guided the evaluation of proximal implementation outcomes. In this manuscript, we present (1) Reach (the number of Black women prescribed PrEP and the proportion of PrEP prescribed to women with an indication, having a sexually transmitted infection (STI) within 12 months and/or reporting >1 sex partners collected from a universal health screener); (2) Adoption (the number of PrEP prescribers); (3) Preliminary Effectiveness (PrEP prescribed over time). Also, we measured the number of Black women who self‐reported talking to a doctor about PrEP as a secondary outcome (Fidelity) . We collected evaluative data from the electronic health record (EHR), sexual health screener and self‐administered post‐visit survey. Descriptive statistics were utilized to describe the sample, and chi‐square tests examined the relationships between patient characteristics and talking to providers about PrEP. Analyses were completed in October 2025. Results: EHR data indicate there were 1274 unique first clinic visits. Most women identified as Black race (58%) and, on average, were 34 (±11.3) years old. Ten PrEP prescriptions were written by seven prescribers (i.e. adoption). Among women prescribed PrEP, nine identified as Black women and none had a recent STI (i.e. reach). PrEP was prescribed once before the pilot, eight times during the pilot and once in the month after the pilot. However, PrEP was not prescribed to women with PrEP indications ( N = 85) (i.e. preliminary effectiveness). Nearly half (43%) of surveyed women reported talking to a provider about PrEP (i.e. fidelity); most (49%) identified as Black race. Chi‐square tests show significant differences by race ( p = 0.02). Conclusions: We observed an increase in PrEP prescriptions from before to during the pilot period; however, 85 women with PrEP indications were not prescribed PrEP. Future research will further evaluate PrEP4Her's acceptability and feasibility.