# Implementation Research to Enhance Equity- Focused HIV Prevention in New York City

> **NIH ALLCDC U01** · HUNTER COLLEGE · 2021 · $1,124,226

## Abstract

7.1. PROJECT SUMMARY/ABSTRACT -- CORE Project
One of the fundamental challenges to effective implementation of HIV prevention interventions is the
engagement of clients who are eligible for and would benefit most from them. This Core Project is focused on
this critical implementation problem: the need to develop and test novel implementation strategies that increase
engagement, uptake, and sustainment of proven HIV prevention interventions, including rapid testing,
PrEP/PEP, and iART. Based on a review of the research literature and data collected directly from community
members in their EHE high priority jurisdictions, the New York City Health Department (NYC HD) has identified
three core determinants of this HIV prevention implementation problem: (1) clients’ anticipated and experienced
stigma and discrimination limit acceptability and uptake; (2) providers’ implicit and explicit bias limit offers and
dissemination; and (3) systemic emphasis on siloed services and risk-based eligibility limits access and
availability. In response to this problem, the NYC HD has chosen an implementation strategy called the GOALS
Approach to Sexual Health, which is designed to: a) universalize and normalize HIV prevention conversations
and interventions; and b) disseminate a client-centered, gender-affirming, non-discriminating, anti-stigmatizing
and trauma-informed approach to sexual history and HIV prevention conversations. This Core Project uses a
two-phase cluster-randomized, stepped-wedge implementation trial to evaluate adoption of the implementation
strategy in 20 agencies funded by the NYC HD. Based on an implementation science model, we will examine
outcomes at three levels: a) implementation outcomes (e.g., rates of HIV testing, PrEP uptake, immediate linkage
of newly diagnosed patients to care); b) service outcomes (e.g., equitable distribution of HIV prevention
interventions to highest priority populations); and c) patient outcomes (e.g., impact on city-wide HIV incidence,
engagement in care, and viral suppression). Secondary analysis will also be conducted on hypothesized
mechanisms (i.e., mediators) as defined in the program’s logic model, including dimensions of provider
competence and patients’ experience. Model fidelity data will be collected on enactment of the GOALS Approach
implementation strategy by the NYC HD, and its ability to successfully implement the strategy at each of the
individual agencies. Finally, qualitative data will be collected to assess barriers and facilitators to implementation
at both the health department and agency levels to inform future adaptation and dissemination of the
implementation strategy.
7.2. PROJECT SUMMARY/ABSTRACT -- COLLABORATIVE Project
One of the most persistent challenges in health care provision is quality. It is often easy to determine which or
how many services are being provided to clients by a given agency or program, but it is far more difficult to
determine how well these services are being deliv...

## Key facts

- **NIH application ID:** 10336187
- **Project number:** 1U01PS005239-01
- **Recipient organization:** HUNTER COLLEGE
- **Principal Investigator:** Sarit A Golub
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2021
- **Award amount:** $1,124,226
- **Award type:** 1
- **Project period:** 2021-09-01 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10336187

## Citation

> US National Institutes of Health, RePORTER application 10336187, Implementation Research to Enhance Equity- Focused HIV Prevention in New York City (1U01PS005239-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10336187. Licensed CC0.

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