1731Medicalizing Prevention: Divergent Views of HIV+ and HIV- Women on PrEP and TasP

Background. Pre-Exposure Prophylaxis (PrEP) and Treatment as Prevention (TasP) are biomedical HIV prevention strategies that could have a significant impact on reducing HIV infection rates among U.S. women. This qualitative study examined HIV+ and HIVwomen’s views of these prevention modalities. Methods. Five focus groups, stratified by HIV status were conducted in 2014 with 26 women (11 HIVand 15 HIV+) of the Washington Metropolitan Women’s Interagency HIV Study. Topics discussed included PrEP /TasP knowledge; beliefs and acceptance; barriers and facilitators to use. Results. Participants had no previous knowledge of PrEP and TasP. However, their opinions diverged based on their HIV status. HIVwomen expressed a lot of enthusiasm about PrEP. They wanted to use PrEP and recommend it to others despite concerns about side effects and stigma of using HIV medicines. PrEP would provide a preventive method they could control, and the combination of PrEP and condom use was thought to provide the best preventive approach. In contrast, HIV+ women were less supportive of PrEP based on their knowledge and experience of the side-effects associated with HIV medications, as well as the invasive nature of a comprehensive PrEP package—routine HIV testing, continued condom use, comprehensive HIV prevention and medication adherence counseling. HIV+ women preferred the use of condoms over PrEP given its efficacy, accessibility without prescription, and for preventing other STIs and pregnancy. Both groups agreed that PrEP should be an available intervention for women. Opinions differed on TasP based on HIV status as well. HIVwomen liked the concept of TasP because of the dual benefit for both the HIV+ individual and uninfected partner. In opposition, HIV+ women were concerned with starting medication sooner, potential long-term side effects, and risk of drug resistance with fewer subsequent treatment options. Conclusion. This study identifies potential challenges and opportunities for advancing PrEP/TasP uptake among U.S. women. The results demonstrate the urgent need for appropriate educational and public health campaigns to maximize the potential benefits of these interventions. Disclosures. All authors: No reported disclosures.