Perspectives on Management of Recurrent UTIs Among Black Women

OBJECTIVE: The objective of this study was to explore Black women's perspectives on the management of recurrent UTIs to inform the development of digital interventions. STUDY DESIGN: This qualitative study included 12 Black-identifying women with recurrent UTIs. Participants completed a demographic survey and a semistructured interview conducted by a Black physician. Socioeconomic disadvantage was assessed using the Area Deprivation Index (ADI). Interviews, guided by the Digital Healthcare Equity and Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) frameworks, addressed the use of digital health technology, knowledge, cultural factors, social support, and barriers/facilitators to care. Three coders analyzed transcripts using grounded theory with excellent interrater reliability. RESULTS: Participants had a median age of 60 years; 75% were postmenopausal, and more than 90% had at least a high school education. Half were sexually active in the past year. The median ADI was in the 70th percentile, indicating high socioeconomic disadvantage. Common UTI prevention strategies included increased fluid intake (83%), over-the-counter products (58%), and prescription treatments (41%). Four key themes emerged: (1) despite socioeconomic disadvantage, most participants used a digital health portal to access care and online sources of information, (2) UTIs were viewed as sexually transmitted infections, fueling shame and isolation, (3) participants focused on treatment rather than prevention, and (4) participants recommended early education about UTIs for younger women. CONCLUSIONS: Despite high levels of disadvantage, Black women use digital health technology around UTIs. By centering patient voices, these findings highlight the need to develop culturally responsive care models that integrate digital technology and reframe UTI as a chronic condition, emphasizing prevention over episodic treatment.