"What I Wish I Would've Known before My HIV Diagnosis": Qualitative Insights from Women Living with HIV to Inform HIV Prevention Strategies.

In 2022, cisgender women accounted for one in five HIV diagnoses in the United States. Existing structural, social, and behavioral factors impede women's engagement with HIV prevention strategies including Pre-Exposure Prophylaxis (PrEP) access, condom usage, and uptake of HIV testing. This study explores the perspectives of women living with HIV (WLWH) about factors that may contribute to HIV acquisition and their advice for women who may benefit from HIV prevention strategies. We conducted semistructured interviews with 40 WLWH who were diagnosed on or after January 1, 2000. Interviews were conducted via Zoom and lasted 45-60 min. Interviews were professionally transcribed, coded, and analyzed to identify themes. Guided by the AIDS Risk Reduction Model, this study uses qualitative findings to describe the steps for recognizing and reducing HIV vulnerabilities. The analysis revealed three themes: (1) recognizing HIV risk for oneself and partner, (2) commiting to decreasing HIV risk, and (3) enacting HIV risk reduction strategies. After recognizing the personal and partner characteristics associated with increased HIV risk and committing to reducing that risk through self-love, relationship assertiveness, and boundary setting, women will be better prepared to enact risk reduction strategies. The four most commonly discussed strategies by WLWH included HIV testing, condom usage, PrEP, and avoiding drug use. This study highlights the importance of understanding the experiences of WLWH to inform effective HIV prevention strategies. Insights from these women emphasized the need for increased awareness, empowerment, and accessible resources to support HIV risk recognition and reduction among women.