# Start the conversation: A multi-level PrEP initiative for Black women in NOLA

> **NIH NIH R34** · DUKE UNIVERSITY · 2022 · $299,840

## Abstract

PROJECT SUMMARY
The rate of HIV diagnosis among Black cisgender women in Louisiana is almost 7 times higher than of White
cisgender women. Multi-level implementation strategies are critically needed to reduce HIV infections among
Black cisgender women in New Orleans, Louisiana (NOLA), an Ending the Epidemic priority jurisdiction. Using
findings from our recently-conducted qualitative interviews with Black cisgender women and contributions from
NOLA’s Black Women and PrEP Task Force, we have identified two main barriers that limit PrEP uptake
among Black cisgender women in NOLA: (1) Black cisgender women do not know of other Black cisgender
women taking PrEP, and (2) Black cisgender women are not offered PrEP during routine medical care. To
address these determinants, we propose to develop and pilot a Start the Conversation Initiative that includes
implementation strategies at the patient and provider levels. Aim 1 focuses on developing the patient-level
implementation strategy, a social media campaign. Working with the Black Women and PrEP Task Force and
a local community-based organization that specializes in social media campaigns, we will determine the
content of the social media messages and the type of social media to use. We will conduct 4 focus group
discussions with Black cisgender women to pre-test the social media content. Aim 2 focuses on developing the
provider-level implementation strategies. We will develop a combined-care PrEP model that encourages GYN
residents to (1) start a PrEP conversation with their patients and help them to determine if PrEP is right for
them, and (2) help their patients to determine the best location of PrEP follow-up—either with the GYN
residency clinic or with a routine PrEP provider. We will conduct 12 in-depth interviews (IDIs) with GYN and
routine PrEP providers and establish a working group of GYN residents, GYN residency directors, and current
PrEP providers to inform the combined-care PrEP model. In Aim 3, we will evaluate the implementation of the
Start the Conversation Initiative. We will pilot the strategies at the Louisiana State University (LSU) GYN
residency program over an 8-month period to inform acceptability, feasibility and potential impact. We will first
implement the provider-level strategies, then layer in the patient-level strategies to examine impact on patient
demand (PrEP uptake) and retention. The 8 months of combined implementation will be compared to PrEP
uptake from a comparison GYN clinic at Tulane; one month retention in care outcomes will be measured at
LSU. Implementation outcomes (adoption, fidelity, maintenance) will be assessed through chart review and
triangulated with resident feedback sessions. We will also conduct 24 IDIs each with providers (n=12) and
patients (n=12) to further inform acceptability, feasibility and appropriateness. At the end of the R34, we plan to
submit a larger implementation research proposal with additional sites in the U.S. South to evaluate t...

## Key facts

- **NIH application ID:** 10403104
- **Project number:** 1R34MH129211-01
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Meredith Edwards Clement
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $299,840
- **Award type:** 1
- **Project period:** 2022-01-20 → 2024-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10403104

## Citation

> US National Institutes of Health, RePORTER application 10403104, Start the conversation: A multi-level PrEP initiative for Black women in NOLA (1R34MH129211-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10403104. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*