Black women in Mississippi continue to experience disproportionate rates of HIV, representing 78% of HIV diagnoses among women, despite being only 18.1% of new diagnoses statewide. Pre-exposure prophylaxis (PrEP) is a proven biomedical prevention strategy, yet uptake among Black women remains low. This pilot study assessed the knowledge, perceptions, and practices of obstetrician–gynecologists (OBGYNs) in Mississippi regarding PrEP to inform a broader implementation effort. Following IRB approval, a 36-question survey was distributed to 100 OBGYN providers, with a response rate of 36%. Surveys evaluated provider knowledge of PrEP guidelines, side effects, and recommended lab monitoring, as well as perceptions of PrEP’s safety and efficacy, prescribing comfort, and barriers to implementation.

Although most respondents viewed PrEP as effective and safe, few routinely prescribed it or discussed it with patients. Barriers included limited familiarity with CDC guidelines, uncertainty about baseline and ongoing monitoring, and perceptions of patient-level challenges. Planned qualitative interviews (n=15) and member-checking sessions with clinicians (n=5) will further identify implementation needs and inform training. Overall, the study highlights an urgent need for targeted educational interventions to improve provider knowledge and prescribing practices.

Strengthening OBGYN capacity to integrate PrEP into routine care is critical to reducing HIV incidence and advancing health equity for Black women in Mississippi. Findings will guide a forthcoming statewide, grant-funded initiative to scale PrEP delivery in women’s health settings, supporting the Ending the HIV Epidemic Initiative’s goals and addressing persistent disparities in HIV prevention access and outcomes.