Perspectives of Black women in the United States on salon-based intervention to promote the uptake of pre-exposure prophylaxis (PrEP) for HIV

AIMS AND OBJECTIVES

To understand Black women's perspectives on a pre-exposure prophylaxis (PrEP) education intervention in a salon setting.

BACKGROUND

Black women have a significant lifetime risk of acquiring HIV. Pre-exposure prophylaxis (PrEP) is an effective prevention approach in reducing that risk. Despite this, Black women are least likely to use PrEP.

DESIGN

This was a qualitative study to identify Black women's perspectives on acceptability of a PrEP education intervention in a salon setting using hair stylists. The paper adhered to the COREQ checklist in reporting.

METHODS

Seven focus groups among Black women (n = 44) living in north-central North Carolina were conducted. Ethical approval was obtained. The interview guide included questions on knowledge of PrEP and barriers and facilitators to a PrEP promotion programme in a salon setting.

RESULTS

Conventional content analysis considered content in relation to themes of facilitators, barriers and women's preferences for intervention delivery. Facilitators included the salon characteristics, social culture and relationship with the stylist. Women noted concerns of accuracy of content from stylists and privacy as barriers.

CONCLUSIONS

Participants' trust with their stylists make a PrEP education salon-based intervention feasible. Salon-based interventions are not one-size-fits-all and researchers interested in this setting should tailor interventions to the individual salon. Interventions for PrEP in a salon setting should be culturally appropriate, confidential and consider the potential reach to the social networks of Black women in the salon.

RELEVANCE TO CLINICAL PRACTICE

The insights shared by Black women can contribute to developing a PrEP uptake intervention as a way of reducing new cases of HIV.

Lessons from the field: A mixed methods analysis of hair stylists' reflections on their experience as lay health educators

Beauty salons are unique settings to provide community-based health education. The Speak UP! Salon Project trained hair stylists to deliver health messages related to reducing unintended pregnancy to female clients in the 18-30-year age range. The project ran from 2009 through 2011. Midway through the project, we held focus groups with stylists and administered a questionnaire as concurrent process evaluation measures. Forty-seven of the ninety-three stylists then active in the project attended one of eleven focus groups. The focus groups included questions about stylists' experiences and their reflections on their role as lay health educators. Using Krueger's qualitative methodology, we systematically analyzed the focus group transcripts. Six themes emerged from the focus groups, including stylists' ability to deliver lay health education, increased comfort levels, stylists' self-monitoring, support materials, messaging outside the target audience, and intangible benefits to the stylists. The questionnaire included twenty-six items and provided quantitative support for identified themes. Findings indicated that stylists were a strong and willing community partner for delivering health education, they received substantial positive feedback from clients, and their efforts reached individuals far beyond the target audience; however, professional health educators must provide substantial training and support to ensure the program's success.