# A structural HIV prevention intervention targeting high-risk women

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2020 · $154,040

## Abstract

Project Summary
 Three decades into the HIV epidemic, high HIV/STI rates persist among FSWs throughout the world,
and research on this population in the U.S. is scarce. FSWs experience a unique set of vulnerabilities
associated with structural factors such stigma, and unsafe work environments. These factors inhibit
protective sexual behaviors and seeking of HIV testing, care, and treatment. HIV prevention approaches that
address social and structural vulnerabilities to HIV infection among FSWs have demonstrated effectiveness
worldwide. Yet in the U.S., structural HIV prevention interventions are scarce. Our research has found
extensive structural vulnerability such as high rates of homelessness, hunger, and violence, as well as high
rates of injection and noninjection drug use among street-based FSWs. We are currently in the 4th year of “A
structural HIV prevention intervention targeting high-risk women” (R01DA041243) – the “EMERALD” study -
that focuses on developing and evaluating a unique and innovative structural intervention aimed to reduce
the burden of HIV, STIs, and problematic drug use among FSW. We are requesting a supplement to support
the actual and projected cost of the EMERALD cohort recruitment and follow-up. Briefly, recruitment and
retention expenses are significantly higher than anticipated compared to our prior studies among FSW in
Baltimore. At the current, time, the study population have proved to be less accessible to reach and to follow-
up, which requires more time and effort from our field staff. Further, increasing rates of fatal overdose in
Baltimore, consistent with the local and national opioid epidemic, are impacting our study population and
sample. The supplement’s aims are the following. First, to enable continued expansion (350 to 385 women)
and follow-up the EMERALD cohort to sufficiently examine the effect of exposure to intervention (SPARC
Center) components on HIV/STI risk behaviors (e.g., drug use/unprotected sex), and HIV/STI cumulative
incidence over time in FSWs in the intervention group (n=225) compared to those in the comparison group
(n=160). Secondly, to examine correlates of nonfatal and fatal overdose in the EMERALD cohort (N=385)
given higher than anticipated fatal and nonfatal overdose rates owing to the opioid epidemic. Through Aim 1,
the requested supplement will allow us to both expand our sample as well as intensify follow-up efforts for the
total study sample given the need for more staff intensive up efforts. Aim 2 will allow for a robust
understanding of both nonfatal and fatal overdose deaths, examining the prevalence, incidence, correlates,
and predictors of both self-reported nonfatal and confirmed fatal overdoses, the latter of which through the
National Death Index from the National Center of Health Statistics.

## Key facts

- **NIH application ID:** 10059019
- **Project number:** 3R01DA041243-05S1
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Susan G. Sherman
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $154,040
- **Award type:** 3
- **Project period:** 2016-07-01 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10059019

## Citation

> US National Institutes of Health, RePORTER application 10059019, A structural HIV prevention intervention targeting high-risk women (3R01DA041243-05S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10059019. Licensed CC0.

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