Document resource
Background Cisgender women remain underrepresented in PrEP programs despite global HIV&AIDS statistics showing women accounting for 45% of all new infections in 2024. This study aims to investigate the interplay between behavioral vulnerability, PrEP awareness and engagement in a cisgender female population in a community-based setting.Materials and Methods We performed a cross-sectional analysis including cisgender women accessing a community-based HIV/STI testing service from April to December 2025. Data were collected during peer-led pre-test counseling using the COBATEST platform and a structured ad-hoc survey. A cumulative HIV risk score (0–8) was constructed based on sexually transmitted infections (STIs) diagnosis, ≥2 partners per year, group sex, recreational drug use, irregular STI testing, inconsistent condom use, sex work, sex with cisgender male partners in the previous 12 months, and categorized as 0–1, 2, and ≥3 indicators. Potential PrEP indication was defined according to international guidelines (e.g. CDC, EACS, BHIVA/BASHH) as ≥1 of the following: STI diagnosis, ≥2 partners, group sex, recreational drug use, inconsistent condom use, or sex work in the previous 12 months. PrEP awareness and interest were assessed. Associations were evaluated using chi-square tests. Multivariable binary logistic regression examined independent associations between risk indicators and PrEP interest.Results The study included 250 cisgender women. Overall, 94.4% reported ≥1 guideline-based potential PrEP indication. Based on the cumulative risk score, 3.6% reported 0–1 indicators, 23.6% reported 2, and 72.8% reported ≥3 concurrent indicators ( table 1). PrEP awareness did not significantly differ across cumulative risk categories (77.8%, 69.5%, and 64.3%, respectively; p=0.572). Similarly, PrEP interest was not associated with cumulative vulnerability (11.1%, 22.0%, and 23.1%, respectively; p=0.7). Age distribution did not significantly differ across risk categories (p=0.568), and PrEP interest was not significantly associated with age (p=0.12), despite a descriptive increase in interest among older women. In multivariable analysis, no individual behavioral risk indicator was independently associated with PrEP interest (all p>0.05; McFadden R2=0.027).Conclusions Cisgender women accessing a community-based testing service reported a high cumulative burden of HIV-related behavioral risks, with most meeting at least one guideline-based indication for PrEP use. However, a higher vulnerability was not associated with increased awareness or interest in PrEP. These findings suggest that current prevention strategies may not adequately reach women with higher likelihood of HIV exposure, underlining the need to strengthen PrEP integration within this population.Abstract OC24 Table 1Characteristics of cisgender women accessing a community-based HIV/STI testing service