# Development and Pilot Testing of an Addiction Clinic-Based PrEP Adherence Intervention for Women with Substance Use Disorders

> **NIH ALLCDC U01** · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · 2021 · $257,359

## Abstract

Ethnic-minority women continue to bear a disproportionate burden of the health and social consequences of HIV.
However, research on effective interventions for engaging women with substance use disorders (SUD) in HIV prevention
interventions is lacking. Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention tool but is not widely used
by ethnic minority women. According to the Centers for Disease Control and Prevention, in 2016 only 2.1% of the
women estimated to have PrEP indications filled PrEP prescriptions. This highlights a significant unmet prevention need.
For women who do take PrEP, low adherence to the medication regimen decreases the medication’s ability to prevent
HIV. The reasons for low uptake and adherence among women are not completely understood. Based on our work and
that of others, individual-level barriers include lack of awareness of personal HIV risk, low knowledge of PrEP, and
concerns about stigma. System-level barriers include difficulty accessing providers knowledgeable and willing to
prescribe PrEP. The overarching goal of this research is to develop and pilot test an addiction-clinic based bio-behavioral
intervention for increasing PrEP uptake and adherence among women who engage in high-risk sexual behaviors and
substance use. We will conduct Stage 1A research to identify key issues to address in developing the intervention.
Interview data obtained from women undergoing standard SUD treatment will be used to finalize the design of the pilot
trial (Stage 1B) comparing standard SUD treatment to SUD treatment integrated with PrEP services and adherence
support. The new integrated intervention is expected to include motivational counseling guided by the Information-
Motivation-Behavioral Skills Model (IMB) which seeks to influence behavior change via PrEP education, increasing
motivation for change, and teaching behavioral skills to increase self-efficacy. This novel intervention will be delivered
remotely using the emocha Mobile Health smartphone application and will include contingency management to reward
desired behaviors. We hypothesize that compared to standard treatment, 1) the integrated intervention will result in a
greater proportion of participants who fill their PrEP prescription; 2) (primary hypothesis) the integrated intervention will
result in greater adherence to PrEP in those who fill their prescriptions; and 3) the integrated intervention will be feasible
and acceptable by women (enrollment rate, study retention, and participant satisfaction scores). We will explore these
hypotheses by pursuing three specific aims; 1) Elicit information on knowledge and attitudes about PrEP use and obtain
feedback about the potential design of the integrated intervention; 2) Develop an integrated bio-behavioral intervention to
promote PrEP uptake and adherence in women undergoing treatment for SUD who are at high risk for HIV; and 3) Assess
initial efficacy, feasibility, and acceptability of the integrated i...

## Key facts

- **NIH application ID:** 10285769
- **Project number:** 1U01PS005209-01
- **Recipient organization:** UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
- **Principal Investigator:** Angela Heads
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2021
- **Award amount:** $257,359
- **Award type:** 1
- **Project period:** 2021-06-01 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10285769

## Citation

> US National Institutes of Health, RePORTER application 10285769, Development and Pilot Testing of an Addiction Clinic-Based PrEP Adherence Intervention for Women with Substance Use Disorders (1U01PS005209-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10285769. Licensed CC0.

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