In the United States, Hispanic women have been particularly affected by the HIV epidemic in recent years. Yet they are less likely to use PrEP treatment, a drug that significantly reduces the risk of HIV infection.

So we created a pilot intervention to get more people to know about the drug by adding it to an existing and proven HIV prevention program for heterosexual Hispanic women. All of the pilot participants – none of whom knew about PrEP before – said they were satisfied with the intervention, and the vast majority learned a lot. These results lead us to believe that this could be a good way to reduce HIV rates in the Hispanic community.

We are nurses conducting research on HIV prevention among black and Hispanic women in South Florida.

Together with our team, we developed SEPA+PrEP, a community engagement intervention that is culturally tailored to Hispanic women to promote HIV prevention.

The program builds on the existing SEPA intervention, developed in 1999. SEPA, which stands for health, education, prevention and self-care in Spanish, was developed for Hispanic women ages 18 to 49. It has been shown to increase condom use and reduce intimate partner violence and substance abuse.

To develop SEPA+PrEP, we adapted and updated the original SEPA intervention and added content related to PrEP. We piloted the program with 44 Hispanic women in Miami-Dade County. The women attended three weekly sessions, each lasting two hours. Participants engaged in discussions and role-playing while practicing communication skills and interacting with peers.

None of the participants knew about PrEP before the study, and 70% had not used a condom for vaginal sex in the past three months. More than half said they had no fear of HIV infection before participating in the program.

After the intervention, we used questionnaires and focus groups to measure the acceptability and feasibility of the intervention. All participants reported being satisfied with the intervention and 89% indicated that they understood the information provided.

Overall, SEPA+PrEP was found to be an acceptable and feasible method for educating Hispanic women about PrEP and other forms of HIV prevention, such as condom use and HIV testing.

Why it is important

Although HIV infections in the United States have declined by 12% since 2018, rates among Hispanic women have remained stable.

According to the Pew Research Center, 17 percent of U.S. women are Hispanic, but 21 percent of those infected with HIV are Hispanic.

In 2022, Hispanic women were nearly three times more likely to be diagnosed with HIV than non-Hispanic white women.

Despite high HIV transmission rates among Hispanics, data shows that only 17% of PrEP users in the United States identify as Hispanic. This percentage is significantly lower than the proportion of Hispanics who are actually at risk for HIV.

Researchers have identified two main reasons for this disparity in PrEP use. First, social service providers working with these communities appear unaware that PrEP is readily available and effective, so they rarely offer the drug to Hispanic women as an option for HIV prevention. Second, Hispanic women—especially immigrants—have limited access to health care due to financial barriers and lack of health insurance.

What happens next?

Now that we know that SEPA+PrEP is effective at teaching women how to use PrEP, the next step is to determine whether the program actually compels women to start taking the drug.

In addition, we want to explore whether SEPA+PrEP can address other issues associated with HIV risk, such as domestic violence. Our team is also working to adapt SEPA+PrEP for Black women, who are also disproportionately affected by the HIV epidemic.