RFA-PS-23-001 - Project PrOVIDE: PrEP Optimization Via Implementation, Dissemination, and Evaluation

PROJECT SUMMARY Significant disparities in pre-exposure prophylaxis (PrEP) for HIV prevention exist in the U.S. with cisgender women making up a disproportionately low percentage of PrEP users compared to men. 60% of new HIV diagnoses among women are among Black cisgender women. Challenges exist at each step of the PrEP care continuum, including difficulty identifying Black cisgender women at highest risk for HIV who are most likely to benefit from PrEP, women’s own low self-perception of HIV risk, low levels of PrEP knowledge, and barriers to PrEP initiation and persistence. While there has been growing knowledge of interventions to increase PrEP use among men who have sex with men and transgender women, much less is known about successful implementation strategies to increase uptake and support PrEP persistence among Black cisgender women. Our team’s preliminary mixed methods work identified PrEP implementation strategies for Black cisgender women consisting of: routine PrEP education for patients, standardized provider training, electronic medical record tools, PrEP navigation, clinical champions, and mHealth tools. We propose to adapt, implement, and evaluate the impact of these strategies to improve PrEP care continuum outcomes for Black cisgender women across six counties in the U.S. using implementation science research methods. PrEP implementation planning will guide strategy selection and identification of new implementation strategies. Our team proposes the following aims: AIM 1: Identify, select, and adapt implementation strategies for engaging Black women in the PrEP care continuum in six clinic settings in EHE priority areas (midwest, north, south). AIM 2: Determine the effectiveness of PrOVIDE implementation strategies on PrEP uptake among Black cisgender women across six clinic sites via a hybrid type II study design. AIM 3: Assess and document implementation outcomes and report on key barriers and facilitators related to successful implementation of the implementation strategies using the RE-AIM framework.