Developing and testing a telehealth intervention to increase HIV pre-exposure prophylaxis uptake and adherence

Revised Project Summary: While the HIV epidemic continues to persist, there are effective HIV prevention biomedical interventions. With high adherence, daily oral pre-exposure prophylaxis (PrEP) reduces risk for HIV acquisition. Increasing PrEP uptake and adherence could significantly reduce HIV incidence, but to date there are limited PrEP interventions, especially for populations most impacted by the virus. The scientific premise of this K01 application is that a telehealth delivery model for PrEP could circumvent barriers to PrEP access. There is a strong proof of concept for the proposed approach given that telehealth interventions to enhance PrEP access have been shown to be acceptable and have increased PrEP uptake and adherence. While telehealth interventions have increased utilization of other health services, few studies has investigated the feasibility, acceptability, and efficacy of delivering PrEP health services through a telehealth approach. Overview of project. My long-term goal is to become an independent researcher with expertise in developing and testing telehealth interventions to improve HIV prevention and care outcomes. In Year 1, I will conduct qualitative interviews with HIV-negative participants (n=20), peer educators (n=20), and healthcare providers (n=20) to identify the content, format, and foreseeable challenges to implementing a telemedicine intervention to increase PrEP awareness, uptake, and adherence. In Year 2,-3 I will conduct qualitative interviews (n=30) to iteratively design a telemedicine intervention to increase PrEP uptake and adherence. In Years 4-5, I will conduct a pilot randomized controlled trial (RCT) to test the feasibility, acceptability, and preliminary efficacy of the telemedicine intervention to optimize PrEP adherence over 6 months with 90 PrEP-naïve, HIV-negative participants. My successful completion of the proposed research and training aims will position me to submit a R01 in the final year of this grant to conduct a multisite, RCT to test the intervention’s efficacy.