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This study will identify perceptions of PrEP in women who inject drugs (WWIDs) and develop and pilot test a targeted intervention that will be embedded in a large, urban syringe exchange program through an extensive formative evaluation process. Using perceptual mapping, an innovative marketing evaluation technique, WWIDs' PrEP perceptions will be incorporated into messaging in targeted counseling, materials, and text messaging to encourage PrEP adherence. This will then be tested in a pilot Randomized Controlled Trial (RCT) by comparing it to a general PrEP intervention to assess for uptake and adherence to PrEP, as well as improved self-efficacy and lower decisional conflict.
Women who inject drugs (WWIDs) are at significantly higher risk of contracting HIV due to both needle sharing and sexual behaviors, yet utilize HIV prevention resources less. Analysis of studies testing pre-exposure prophylaxis (PrEP) has not tested effectiveness in WWIDs and little research exists on their specific barriers to uptake and adherence. The result is a significant group who is highly vulnerable to HIV infection and its negative health consequences, yet is less likely to benefit from PrEP. To address this gap this study will use a rigorous formative evaluation strategy utilizing a unique and innovative marketing evaluation technique. Using perceptual mapping and vector modeling analysis, the investigators will develop 3-D maps to identify specific message strategies to embed into an intervention using targeted PrEP counseling, written materials, and text based messaging and pilot tested for promise of efficacy compared to a general PrEP intervention. The intervention will address psycho-social barriers to PrEP through perceptual mapping but also societal and structural barriers by embedding it in a trusted syringe exchange and distributing medication through its medical clinic. Specific aims of the research are: 1. Assess WWIDs' perceptions of PrEP and potential barriers to use. To accomplish this the investigators will conduct focus groups (n=30) and interviews with syringe exchange staff (n=10) and develop a perceptual mapping survey. 2. Develop a targeted communication intervention based on vector modeling findings, including print materials, PrEP counseling, and text messages, and assess feasibility and acceptability. To accomplish this the investigators will conduct perceptual mapping surveys with HIV- WWIDs (n=100), do vector modeling analysis and create sample messages, concept test messages with WWIDs and staff (n=20), create intervention materials and conduct usability testing (n=20). 3. Pilot test the intervention by integrating into a syringe exchange to assess promise of efficacy. To accomplish this the investigators will conduct a randomized pilot (n=50) and test an "enhanced" intervention using targeted messages with a "basic" intervention that provides general PrEP counseling. To assess promise of efficacy the investigators will compare PrEP adherence (blood test; self report) and differences in PrEP attitudes, self-efficacy, and decisional conflict.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Enhanced Intervention | Experimental | Women who are eligible and randomized to the Enhanced Intervention will receive targeted PrEP counseling; targeted written/visual materials, follow up supportive text messages, and distribution of PrEP at the syringe exchange |
|
| Basic Intervention | Active Comparator | Women who are eligible and randomized to the Basic Intervention will receive "usual care" with general messaging from medical personnel, reminder text messages, and distribution of PrEP at the syringe exchange |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Enhanced Intervention | Behavioral | Targeted PrEP counseling; targeted written/visual materials; follow up supportive text messages; distribution of PrEP at the syringe exchange |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in PrEP Uptake and Adherence | Self-report PrEP adherence and bio-verified PrEP adherence to PrEP with urine assay (Synergy medical labs - Descovy Panel TFV:Creatinine Ratio-Descovy). Urine assay results will be categorized as a binary variable (yes/no) based upon value observed by all patients, with data at 1 month, 3 months and 3 months post intervention. | one month, three months, three months post intervention |
| PrEP Adherence Within Past Week | Self report PrEP adherence measure of PrEP use within the past week. Item asks "Of the seven doses of PrEP you were supposed to take during the last week, how many doses would you say you missed? Responses range from 0 to 7. | one month, three months, three months post intervention |
| PrEP Adherence Appraisal | One item Medication Adherence question (one item with 5 option scale). "Excellent, Very good, Good, Poor, Very Poor". | one month, three months, three months post intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Coping Self-Efficacy | Assess coping self-efficacy using the Coping Self-Efficacy Scale (13 item scale; 0-10 scale). Zero=cannot do at all,5=moderately certain can do and 10=certain can do. An overall CSE score (from 0 to 130) is created by summing the item ratings, with higher scores indicating higher coping self-efficacy. | Three months, three months post-intervention |
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Inclusion Criteria:
Exclusion Criteria:
Any self-reported women who injects drugs or has other HIV risk related to drug use
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| Name | Affiliation | Role |
|---|---|---|
| Sarah B Bass, PhD, MPH | Temple University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Prevention Point Philadelphia | Philadelphia | Pennsylvania | 19134 | United States |
All research products from the study will be made available to other qualified individuals within the scientific community, government agencies and other interested parties after publication of results. Requests for raw data from other scientists will be considered with provision of the following information: A brief description of the specific aims and/or hypotheses, data requirements, and proposed analyses, how the data will be used, timeframe for use, and Institutional Review Board (IRB) approvals. All materials developed during the study, as well as any research instruments, will also be made available upon request. In addition, qualified individuals who are interested in the PrEP messaging and the methods from which they are created, as well as the analysis methods generated by this research, will have access after publication. It is our full intention to share all findings generated by this study, and subsequent lessons learned, with others in the scientific community.
Three months after end of intervention data collection.
Access to trial IPD can be requested by qualified researchers engaging in independent scientific research, and will be provided following review and approval of a research proposal and Statistical Analysis Plan (SAP) and execution of a Data Sharing Agreement (DSA).
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A total of 35 participants were randomized to intervention or control arms. IRB required us to consent women prior to eligibility due to HIPAA. In total, forty nine women were recruited and 48 consented for the study prior to eligibility. Of these, 12 were found to be not eligible based on criteria (i.e. previously used PrEP, no reported HIV risk behavior, no phone). Of the 36 remaining, one was lost before randomization could occur, resulting in a final group of 35 participants.
Participants were recruited for the pilot clinical trial from September 2020 to September 2021. Participants were recruited for the formative work that was done prior to developing the intervention on June 1, 2018. All were self-identified females who were clients of Prevention Point Philadelphia, a social services agency and syringe services exchange.
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| ID | Title | Description |
|---|---|---|
| FG000 | Enhanced Intervention | Women who are eligible and randomized to the Enhanced Intervention will receive targeted PrEP counseling; targeted written/visual materials, follow up supportive text messages, and distribution of PrEP at the syringe exchange Enhanced Intervention: Targeted PrEP counseling; targeted written/visual materials; follow up supportive text messages; distribution of PrEP at the syringe exchange |
| FG001 | Basic Intervention | Women who are eligible and randomized to the Basic Intervention will receive "usual care" with general messaging from medical personnel, reminder text messages, and distribution of PrEP at the syringe exchange Basic Intervention: General messaging from medical personnel; reminder text messages; distribution of PrEP at the syringe exchange |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
The number of participants in the Baseline Analysis Population only includes participants who completed the baseline survey in its entirety. 35 participants were randomized to a condition. However, 2 participants were later deemed ineligible as they had previously taken PrEP. 2 additional participants did not complete the baseline assessment in its entirety. In total, 31 participants were randomized, eligible, and completed baseline.
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| ID | Title | Description |
|---|---|---|
| BG000 | Enhanced Intervention | Women who are eligible and randomized to the Enhanced Intervention will receive targeted PrEP counseling; targeted written/visual materials, follow up supportive text messages, and distribution of PrEP at the syringe exchange Enhanced Intervention: Targeted PrEP counseling; targeted written/visual materials; follow up supportive text messages; distribution of PrEP at the syringe exchange |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change in PrEP Uptake and Adherence | Self-report PrEP adherence and bio-verified PrEP adherence to PrEP with urine assay (Synergy medical labs - Descovy Panel TFV:Creatinine Ratio-Descovy). Urine assay results will be categorized as a binary variable (yes/no) based upon value observed by all patients, with data at 1 month, 3 months and 3 months post intervention. | The enhanced intervention group analysis population at 1 month (n=3) differs from the overall enhanced intervention group n (17), and basic intervention group analysis population at 1 month (n=4) differs from the overall basic intervention group n (14) due to implementation barriers that prevented women from getting onto PrEP (e.g., lack of venous access, not returning for doctor appointment), and remaining adherent (failure to pick up meds, failure to show for appointments). | Posted | Count of Participants | Participants | one month, three months, three months post intervention |
|
Six months - baseline, intervention (three months), three month followup
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Enhanced Intervention | Women who are eligible and randomized to the Enhanced Intervention will receive targeted PrEP counseling; targeted written/visual materials, follow up supportive text messages, and distribution of PrEP at the syringe exchange Enhanced Intervention: Targeted PrEP counseling; targeted written/visual materials; follow up supportive text messages; distribution of PrEP at the syringe exchange |
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Limitations were: 1.COVID-19 - delayed/disrupted recruitment efforts; 2. 51% of randomized participants were lost-to-follow-up prior to receiving a PrEP prescription due to lack of venous access and lag time getting to see an HIV tester or doctor who were only available certain days due to COVID-19 protocols; 3. Time to engage women for time necessary to complete baseline procedures, HIV testing, and bloodwork as the need to use drugs to avoid withdrawal symptoms superseded study participation.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Sarah Bass | Temple University | 215-204-5110 | sbass@temple.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP_ICF | Yes | Yes | Yes | Study Protocol, Statistical Analysis Plan, and Informed Consent Form | May 17, 2021 | May 23, 2023 | Prot_SAP_ICF_000.pdf |
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| ID | Term |
|---|---|
| D000163 | Acquired Immunodeficiency Syndrome |
| ID | Term |
|---|---|
| D015658 | HIV Infections |
| D000086982 | Blood-Borne Infections |
| D003141 | Communicable Diseases |
| D007239 | Infections |
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Women participants will be randomized to condition upon consent based on a random numbers table. Intervention arm will get "enhanced" intervention with customized messages and counseling/text messaging; control arm will get "basic" intervention with medical counseling and text message reminders.
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| Basic Intervention | Behavioral | General messaging from medical personnel; reminder text messages; distribution of PrEP at the syringe exchange |
|
| Decisional Conflict | Assess decisional conflict with the Ottawa Decisional Conflict Scale. 13 items. 5 responses: Strongly Disagree (1), Disagree (2), Neither Agree or Disagree (3), Agree (4), Strongly Agree (5). Scores are summed and divided by the number of items(13) to produce an overall mean, ranging from 1 to 5. Lower scores indicate lower decisional conflict. | Three months, Three months post intervention |
| PrEP Benefits | 10 items assessed perceived benefits of PrEP. Items are asked on a 0-10 Likert, with 0 = strongly agree, 5 = unsure, 10 = strongly agree. Thus, higher scores indicate greater agreement with that item. | three months, three months post-intervention |
| PrEP Barriers | 12 items assessed perceived barriers to taking PrEP. Items are asked on a 0-10 Likert, with 0 = strongly disagree, 5 = unsure, 10 = strongly agree. Thus, higher score indicates greater agreement with that item. | Three months, Three month post intervention |
| PrEP Beliefs | 9 items assessed perceived beliefs about PrEP. Items are asked on a 0-10 Likert, with 0 = strongly disagree, 5 = unsure, 10 = strongly agree. Thus, higher score indicates greater agreement with that item. | Three month, Three month post intervention |
| Found out previously on PrEP after randomization before eligibility was expanded |
|
| BG001 | Basic Intervention | Women who are eligible and randomized to the Basic Intervention will receive "usual care" with general messaging from medical personnel, reminder text messages, and distribution of PrEP at the syringe exchange Basic Intervention: General messaging from medical personnel; reminder text messages; distribution of PrEP at the syringe exchange |
| BG002 | Total | Total of all reporting groups |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Coping Self-Efficacy | Assess coping self-efficacy using the Coping Self-Efficacy Scale (13 item scale; 0-10 scale). Zero=cannot do at all,5=moderately certain can do and 10=certain can do. An overall CSE score (from 0 to 130) is created by summing the item ratings, with higher scores indicating higher coping self-efficacy. | Analysis population only includes cases that completed baseline. Note that one item of the CSE scale was inadvertently excluded from the baseline measure. Random imputation was used to populate a value from 0-10 for this missing item value prior to scoring the CSE. | Mean | Standard Deviation | units on a scale |
|
| Decisional Conflict | Assess decisional conflict with the Ottawa Decisional Conflict Scale. 13 items. 5 responses: Strongly Disagree (1), Disagree (2), Neither Agree or Disagree (3), Agree (4), Strongly Agree (5). The scores on the 13 items were summed and then divided by the number of items (13) to produce an overall mean, ranging from 1 to 5. The lower the score, the lower the decisional conflict. A mean of 4 is considered higher decisional conflict. | Mean | Standard Deviation | units on a scale |
|
| PrEP Benefits | 10 items assessed perceived benefits of PrEP. Items are asked on a 0-10 Likert, with 0 = strongly disagree, 5 = unsure, 10 = strongly agree. Thus, higher score indicates greater agreement with that item. | Mean | Standard Deviation | units on a scale |
|
| PrEP Barriers | 12 items assessed perceived barriers to taking PrEP. Items are asked on a 0-10 Likert, with 0 = strongly disagree, 5 = unsure, 10 = strongly agree. Thus, higher score indicates greater agreement with that item. | Mean | Standard Deviation | units on a scale |
|
| PrEP Beliefs | 9 items assessed perceived beliefs about PrEP. Items are asked on a 0-10 Likert, with 0 = strongly disagree, 5 = unsure, 10 = strongly agree. Thus, higher score indicates greater agreement with that item. | One participant in the enhanced group did not provide a response to item "PrEP sounds too good to be true". Thus, the analysis population was reduced from 17 to 16. | Mean | Standard Deviation | units on a scale |
|
Women who are eligible and randomized to the Enhanced Intervention will receive targeted PrEP counseling; targeted written/visual materials, follow up supportive text messages, and distribution of PrEP at the syringe exchange Enhanced Intervention: Targeted PrEP counseling; targeted written/visual materials; follow up supportive text messages; distribution of PrEP at the syringe exchange |
| OG001 | Basic Intervention | Women who are eligible and randomized to the Basic Intervention will receive "usual care" with general messaging from medical personnel, reminder text messages, and distribution of PrEP at the syringe exchange Basic Intervention: General messaging from medical personnel; reminder text messages; distribution of PrEP at the syringe exchange |
|
|
| Primary | PrEP Adherence Within Past Week | Self report PrEP adherence measure of PrEP use within the past week. Item asks "Of the seven doses of PrEP you were supposed to take during the last week, how many doses would you say you missed? Responses range from 0 to 7. | Enhanced group at 1month (n=3) differs from the overall enhanced group n (17) & basic group at 1 month (n=4) differs from overall basic group n (14) due to implementation barriers that prevented PrEP uptake (e.g., lack of venous access, not returning for doctor appointment), and remaining PrEP adherent (failure to pick up meds, failure to show for appointments). Drop off at 3 month is due to lost to follow up & dropout. No participant at 3 month follow up reported PrEP use. | Posted | Count of Participants | Participants | one month, three months, three months post intervention |
|
|
|
| Primary | PrEP Adherence Appraisal | One item Medication Adherence question (one item with 5 option scale). "Excellent, Very good, Good, Poor, Very Poor". | Enhanced group at 1month (n=3) differs from the overall enhanced group n (17) & basic group at 1 month (n=4) differs from overall basic group n (14) due to implementation barriers that prevented PrEP uptake (e.g., lack of venous access, not returning for doctor appointment), and remaining PrEP adherent (failure to pick up meds, failure to show for appointments). Drop off at 3 month is due to lost to follow up & dropout. No participant at 3 month follow up reported PrEP use. | Posted | Count of Participants | Participants | one month, three months, three months post intervention |
|
|
|
| Secondary | Coping Self-Efficacy | Assess coping self-efficacy using the Coping Self-Efficacy Scale (13 item scale; 0-10 scale). Zero=cannot do at all,5=moderately certain can do and 10=certain can do. An overall CSE score (from 0 to 130) is created by summing the item ratings, with higher scores indicating higher coping self-efficacy. | Analysis at 3 month and 3 month follow up only includes participants that remained in the study. | Posted | Mean | Standard Deviation | units on a scale | Three months, three months post-intervention |
|
|
|
| Secondary | Decisional Conflict | Assess decisional conflict with the Ottawa Decisional Conflict Scale. 13 items. 5 responses: Strongly Disagree (1), Disagree (2), Neither Agree or Disagree (3), Agree (4), Strongly Agree (5). Scores are summed and divided by the number of items(13) to produce an overall mean, ranging from 1 to 5. Lower scores indicate lower decisional conflict. | Enhanced group at 3 month (n=1) differs from the overall enhanced group n (17) & basic group at 3 month (n=3) differs from overall basic group n (14) due to implementation barriers that prevented PrEP uptake (e.g., lack of venous access, not returning for doctor appointment), and remaining PrEP adherent (failure to pick up meds, failure to show for appointments). Drop off at 3 month is due to lost to follow up & dropout. | Posted | Mean | Standard Deviation | units on a scale | Three months, Three months post intervention |
|
|
|
| Secondary | PrEP Benefits | 10 items assessed perceived benefits of PrEP. Items are asked on a 0-10 Likert, with 0 = strongly agree, 5 = unsure, 10 = strongly agree. Thus, higher scores indicate greater agreement with that item. | Enhanced group at 3 month (n=1) differs from the overall enhanced group n (17) & basic group at 3 month (n=3) differs from overall basic group n (14) due to implementation barriers that prevented PrEP uptake (e.g., lack of venous access, not returning for doctor appointment), and remaining PrEP adherent (failure to pick up meds, failure to show for appointments). Drop off at 3 month is due to lost to follow up & dropout. | Posted | Mean | Standard Deviation | units on a scale | three months, three months post-intervention |
|
|
|
| Secondary | PrEP Barriers | 12 items assessed perceived barriers to taking PrEP. Items are asked on a 0-10 Likert, with 0 = strongly disagree, 5 = unsure, 10 = strongly agree. Thus, higher score indicates greater agreement with that item. | Enhanced group at 3 month (n=1) differs from the overall enhanced group n (17) & basic group at 3 month (n=3) differs from overall basic group n (14) due to implementation barriers that prevented PrEP uptake (e.g., lack of venous access, not returning for doctor appointment), and remaining PrEP adherent (failure to pick up meds, failure to show for appointments). Drop off at 3 month is due to lost to follow up & dropout. | Posted | Mean | Standard Deviation | units on a scale | Three months, Three month post intervention |
|
|
|
| Secondary | PrEP Beliefs | 9 items assessed perceived beliefs about PrEP. Items are asked on a 0-10 Likert, with 0 = strongly disagree, 5 = unsure, 10 = strongly agree. Thus, higher score indicates greater agreement with that item. | Enhanced group at 3 month (n=1) differs from the overall enhanced group n (17) & basic group at 3 month (n=3) differs from overall basic group n (14) due to implementation barriers that prevented PrEP uptake (e.g., lack of venous access, not returning for doctor appointment), and remaining PrEP adherent (failure to pick up meds, failure to show for appointments). Drop off at 3 month is due to lost to follow up & dropout. | Posted | Mean | Standard Deviation | units on a scale | Three month, Three month post intervention |
|
|
|
| 0 |
| 17 |
| 0 |
| 17 |
| 0 |
| 17 |
| EG001 | Basic Intervention | Women who are eligible and randomized to the Basic Intervention will receive "usual care" with general messaging from medical personnel, reminder text messages, and distribution of PrEP at the syringe exchange Basic Intervention: General messaging from medical personnel; reminder text messages; distribution of PrEP at the syringe exchange | 0 | 14 | 0 | 14 | 0 | 14 |
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| D015229 |
| Sexually Transmitted Diseases, Viral |
| D012749 | Sexually Transmitted Diseases |
| D016180 | Lentivirus Infections |
| D012192 | Retroviridae Infections |
| D012327 | RNA Virus Infections |
| D014777 | Virus Diseases |
| D012897 | Slow Virus Diseases |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D007153 | Immunologic Deficiency Syndromes |
| D007154 | Immune System Diseases |
| Native Hawaiian or Other Pacific Islander |
|
| Black or African American |
|
| White |
|
| More than one race |
|
| Unknown or Not Reported |
|
| Still taking PrEP, not bio-verified |
|
| Not taking PrEP |
|
| Still taking PrEP, not bio-verified |
|
| Not taking PrEP |
|
| 6 days |
|
| 5 days |
|
| 4 days |
|
| 3 days |
|
| 2 days |
|
| 1 day |
|
| 0 days |
|
| Unknown or not reported |
|
| 3 month |
|
|
| 3 month follow up |
|
|
| Very good |
|
| Good |
|
| Poor |
|
| Very poor |
|
| Unknown or not reported |
|
| 3 month |
|
|
| 3 month follow up |
|
|
| 3 month follow up |
|
|
| 3 month follow up |
|
|
| 3mo, Using PrEP would make me feel more in charge of my life |
|
|
| 3mo, I would be able to enjoy sex more if I was taking PrEP |
|
|
| 3mo, PrEP is easy to take |
|
|
| 3mo, PrEP would not interfere with me injecting or taking drugs |
|
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| 3mo, I would not have to rely on my partner to use condoms if I was taking PrEP |
|
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| 3mo, I would only have to take one pill a day if I was on PrEP |
|
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| 3mo, PrEP would let me worry less about HIV |
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| 3mo, I would not have to feel guilty about having fun if I took PrEP |
|
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| 3mo, PrEP is affordable |
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| 3mofu, PrEP can keep me from getting HIV |
|
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| 3mofu, Using PrEP would make me feel more in charge of my life |
|
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| 3mofu, I would be able to enjoy sex more if I was taking PrEP |
|
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| 3mofu, PreP is easy to take |
|
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| 3mofu, PrEP would not interfere with me injecting or taking drugs |
|
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| 3mofu, I would not have to rely on my partner to use condoms if I was taking PrEP |
|
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| 3mofu, I would only have to take one pill a day if I Was on PrEP |
|
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| 3mofu, PrEP would let me worry less about HIV |
|
|
| 3mofu, I would not have to feel guilty about having fun if I took PrEP |
|
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| 3mofu, PrEP is affordable |
|
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| 3mo, Taking PrEP would dull my high |
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| 3mo, Taking PrEP would cause too many side effects |
|
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| 3mo, I feel healthy so I don't need to take PrEP |
|
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| 3mo, I already protect myself from HIV in other ways (condoms, not sharing needles) |
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| 3mo, Even if I take PrEP, I might get HIV anyway |
|
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| 3mo, PrEP only protects against HIV, not other sexually transmitted infections |
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| 3mo, My partner might hurt me if they knew I was on PrEP |
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| 3mo, I have a lot more worries in my life than getting HIV |
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| 3mo, If i started PreP it would be hard to get to the doctor every 3 months |
|
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| 3mo, I don't have a safe place to keep PrEP |
|
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| 3mo, I would be afraid if I had PrEP it would get stolen |
|
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| 3mofu, It would be hard for me to take a pill every day |
|
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| 3mofu, Taking PrEP would dull my high |
|
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| 3mofu, Taking PrEP would cause too many side effects |
|
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| 3mofu, I feel healthy so I don't need to take PrEP |
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| 3mofu, I already protect myself from HIV in other ways (condoms, not sharing needles) |
|
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| 3mofu, Even if I take PrEP, I might get HIV anyway |
|
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| 3mofu, PrEP only protects against HIV, not other sexually transmitted infections |
|
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| 3mofu, My partner might hurt me if they knew I was on PrEP |
|
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| 3mofu, I have a lot more worries in my life than getting HIV |
|
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| 3mofu, If i started PreP it would be hard to get to the doctor every three months |
|
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| 3mofu, I don't have a safe place to keep PrEP |
|
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| 3mofu, I would be afraid if I had PrEP it would get stolen |
|
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| 3mo, People who inject drugs need PrEP more than other people |
|
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| 3mo, Gay men need PrEP more than other people |
|
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| 3mo, Trans people need PrEP more than other people |
|
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| 3mo, People from certain races/ethnicities need PrEP more than other people |
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| 3mo, PrEP sounds too good to be true |
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| 3mo, PrEP makes people think they are invincible (can't get HIV or other sexually transmitted infect |
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| 3mo, PrEP is safe and effective for women to use |
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| 3mo, I am more likely to take PrEP if I am being paid to take it |
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| 3mofu, Sex workers need PrEP more than other people |
|
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| 3mofu, People who inject drugs need PrEP more than other people |
|
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| 3mofu, Gay men need PrEP more than other people |
|
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| 3mofu, Trans people need PrEP more than other people |
|
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| 3mofu, People from certain races/ethnicities need PrEP more than other people |
|
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| 3mofu, PrEP sounds too good to be true |
|
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| 3mofu, PrEP makes people think they are invincible (can't get HIV or other STIs) |
|
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| 3mofu, PrEP is safe and effective for women to use |
|
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| 3mofu, I am more likely to take PrEP if I am being paid to take it |
|
|