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Get PrEPPT (pre-exposure prophylaxis and pregnancy termination): an exploration of the values, attitudes and preferences regarding HIV and PrEP among women seeking abortion
  1. Jessika Ann Ralph1,
  2. Chen Yeh2,
  3. Allison Cowett1,
  4. Lisa R Hirschhorn3,
  5. Cassing Hammond1
  1. 1Obstetrics and Gynecology, Section of Family Planning, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
  2. 2Preventive Medicine, Division of Biostatistics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
  3. 3Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
  1. Correspondence to Dr Jessika Ann Ralph, Obstetrics and Gynecology, Section of Family Planning, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; ralph044{at}


Introduction Pre-exposure prophylaxis (PrEP) for the prevention of HIV transmission is under utilised by women in the US. Women seeking abortion have a higher HIV prevalence than women who continue prenatal care and could benefit from HIV risk assessment and PrEP counselling. We assessed the knowledge, attitudes, and preferences of women seeking abortion care regarding their HIV risk and knowledge of PrEP, and identified individual and system barriers to PrEP access.

Methods We performed a cross sectional descriptive study of English speaking women at a freestanding abortion clinic through an anonymous survey. Participants with indications for PrEP care included those who performed sex work, experienced a recent sexually transmitted infection, or had multiple sexual partners and inconsistent condom use. We performed descriptive statistics on response data; Wilcoxon tests were used to compare continuous variables across groups.

Results 64 (32.3%) participants had indications for PrEP, but only 31 (16.1%) had previous knowledge of PrEP. After the concept was explained, attitudes towards PrEP were generally positive, and 54 participants (27.8%) would consider starting PrEP in the next 6 months. Participants were most interested in receiving PrEP care from their primary care provider rather than from an abortion clinic.

Conclusions Among women seeking abortion, women vulnerable to HIV infection outnumbered those with PrEP knowledge by 2 to 1. Prior knowledge of PrEP as an HIV prevention method was low, but women found PrEP acceptable. While women reported preferring to receive PrEP from a primary care provider, the abortion clinic visit may also represent an important time for HIV education and risk screening.

  • abortion
  • surveys
  • human immunodeficiency virus

Statistics from


  • Presented at A portion of these data was presented as an oral abstract at the Annual Meeting of the Fellowship in Family Planning, May 2019.

  • Contributors JAR, HC, AC and LRH planned the study. JAR recruited participants and collected data. CY and JAR performed the data analysis. JAR prepared the manuscript. HC, CY, AC and LRH revised the manuscript.

  • Funding This project was funded by the Society of Family Planning Research Fund (SFPRF18-26).

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval This study was reviewed by the institutional review board of Northwestern University prior to participant recruitment and was found to be exempt.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available. Deidentified participant data are stored in REDCap, licensed by Northwestern University. Data can be made available after a data use agreement between institutions is arranged and approved by Northwestern’s Office of Sponsored Research.

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