# Implementation science research on PrEP delivery and costing within MAT and NSP services for PWUD in Uganda

> **NIH NIH R01** · UNIVERSITY OF WASHINGTON · 2021 · $9,019

## Abstract

ABSTRACT
In the past decade, Uganda seen increases – as large as 10-fold – in the number of people who use drugs
(PWUD) and the risk for HIV transmission through shared injection equipment, a common practice in this setting
with low access to clean equipment. HIV prevalence among PWUD has been estimated to be as high as
45%, highlighting the importance of widescale access to HIV treatment and prevention for PWUD,
including oral pre-exposure prophylaxis (PrEP). PrEP was integrated into HIV prevention guidelines in
Uganda in 2016 and PEPFAR funding has been supporting targeted rollout to key populations, including PWUD.
However, <250 people currently accessing PrEP have identified as PWUD, indicating a large gap in prevention
and an opportunity to optimize PrEP delivery for PWUD. For PWUD living with HIV, antiretroviral treatment has
been integrated into medication assisted treatment (MAT) programs and needle and syringe exchange programs
(NSP), by leveraging providers who empathize with addiction and have experience combating stigma associated
with drug use. We hypothesize that a similar approach can be done for PrEP by integrating PrEP delivery
into MAT and NSP programs and we proposed a staged approach to conduct formative work and refine
two integrated programs (PrEP + MAT and PrEP + NSP), to pilot these programs and assess PrEP uptake,
retention, and adherence and to conduct costing research to directly inform policy guidance. Our work
will be conducted with attention to several constructs within the Consolidated Framework for Implementation
Research and grounded in a participatory approach with members of the largest harm reduction network, police
force, and PWUD in Uganda as project advisors. Specifically, we aim to: 1) conduct qualitative research to
explore preferences for HIV prevention services and willingness to use/prescribe PrEP among PWUD and
providers of a) oral PrEP and b) services for PWUD in Kampala, Uganda; 2) refine programs for community-
based NSP + PrEP and facility-based MAT + PrEP; 3) compare PrEP uptake, retention, and adherence when
PrEP is integrated into community-based NSP versus facility-based MAT to PWUD; and 4) estimate the
programmatic costs and conduct budget impact analysis for integrating PrEP into our MAT and NSP programs.
Impact. The proposed work will provide robust evidence about how to optimize integrated harm reduction and
PrEP delivery to PWUD in Uganda and similar settings. With direct engagement from members of the Ugandan
Ministry of Health on our investigative team, our findings will be immediately useful for policy guidelines and to
guide programmatic scale-up. This work will be relevant to the US and globally as a demonstration of co-located
harm reduction and HIV prevention services for PWUD and it will provide some of the first data on PrEP
adherence and retention among PWUD.

## Key facts

- **NIH application ID:** 10404447
- **Project number:** 3R01DA051796-02S1
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Renee A. Heffron
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $9,019
- **Award type:** 3
- **Project period:** 2020-08-01 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10404447

## Citation

> US National Institutes of Health, RePORTER application 10404447, Implementation science research on PrEP delivery and costing within MAT and NSP services for PWUD in Uganda (3R01DA051796-02S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10404447. Licensed CC0.

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