# Testing implementation strategies to improve delivery of PrEP for pregnant and postpartum women in Kenya

> **NIH NIH K01** · UNIVERSITY OF WASHINGTON · 2021 · $170,423

## Abstract

ABSTRACT
This implementation science K01 research and training grant aims to optimize the delivery of pre-exposure
prophylaxis (PrEP) for pregnant and postpartum women. Pregnancy is a high-risk time for HIV acquisition. As
prevention of mother-to-child transmission (PMTCT) programs become more effective, a greater proportion of
new infant infections will be due to incident infection during pregnancy. PrEP is an effective, female-controlled,
evidence-based intervention that is recommended during pregnancy in high-risk regions in both World Health
Organization and Kenyan guidelines. An implementation science approach will be needed to improve
operationalization and scale-up of PrEP delivery during pregnancy. An ongoing 20-site R01 trial (MPI: John-
Stewart, Baeten) and a recently completed 16-site project (MPI: John-Stewart, Baeten) are the first and largest
projects to deliver PrEP during pregnancy within antenatal care clinics (ANC). The proposed K01 will leverage
the experiences of health care workers (HCW) and the heterogeneity between sites, to identify and test ways
of improving PrEP delivery. This project’s research aims (R1-3) are to R1) identify determinants of successful
PrEP delivery during ANC using mixed-methods, R2) select and test specific implementation strategies to
improve PrEP delivery fidelity and penetration using interrupted time series analyses, and R3) quantify the
budget impact of modifications to PrEP delivery during ANC and understand policymaker decisions. The
research aims of this study will allow Dr. Wagner the opportunity to meet her training aims (T1-6), including:
T1) learning implementation science frameworks, outcome measurement, and implementation strategy
identification and testing, T2) learn quasi-experimental research designs, T3) conduct budget impact analyses,
T4) understand policymaker decision-making processes, T5) learn about responsible conduct of research with
pregnant women, and T6) build her scientific record and transition to independence. These research and
training goals will prepare Dr. Wagner to transition to independence; she will plan to submit an R01 cluster
randomized trial to test a package of implementation strategies to improve successful delivery of PrEP during
ANC. Dr. Wagner will complete her K01 career development training at the University of Washington, which is
a superb environment for training in implementation science and health economics, with a strong >25 year
history of collaboration with Kenyan institutions, and with outstanding mentorship from implementation
scientists, PrEP experts, leaders in HIV prevention during pregnancy, and policymakers.

## Key facts

- **NIH application ID:** 10214474
- **Project number:** 5K01MH121124-03
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Anjuli Dawn Wagner
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $170,423
- **Award type:** 5
- **Project period:** 2019-08-06 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10214474

## Citation

> US National Institutes of Health, RePORTER application 10214474, Testing implementation strategies to improve delivery of PrEP for pregnant and postpartum women in Kenya (5K01MH121124-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10214474. Licensed CC0.

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