# Improving the HIV PrEP Cascade using an Intervention for Healthcare Providers

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2021 · $161,498

## Abstract

Parent Award Project Summary/Abstract
HIV pre-exposure prophylaxis (PrEP) has been shown to be highly effective for HIV prevention in randomized
clinical trials but uptake of PrEP in the U.S. has been limited. One of the barriers to PrEP implementation is
lack of healthcare provider (HCP) knowledge and willingness to prescribe it. As outcomes of current PrEP
formulations in real-world settings and different populations are reported and novel PrEP formulations are
introduced, HCPs will continue to require support and guidance to optimize the clinical and public health impact
of this valuable HIV prevention strategy. We propose a PrEP optimization intervention targeted at HCPs to
increase PrEP uptake and persistence among those at risk for HIV acquisition. This intervention includes: (1)
an integrated web-based panel management tool called PrEP-Rx, which provides structured HIV risk
assessment, automates reminders for laboratory testing and appointments, and reports patients' history of
PrEP use; and (2) a centralized PrEP coordination overseen by a clinical support staff (referred to as the PrEP
coordinator) who can identify individuals at high risk for HIV through direct patient contact or by reviewing
registries for sexually transmitted infections (STIs) and who can support multiple HCPs. We propose the
following aims: Primary Aim: Evaluate the efficacy of the PrEP optimization intervention (PrEP Coordinator +
PrEP-Rx) to increase PrEP prescriptions through a stepped-wedge design among 10 primary care clinics. We
hypothesize that the mean number of prescriptions issued will be significantly higher when the clinics use the
PrEP intervention versus when they do not. Secondary Aims: (1) Explore differences in PrEP initiation,
duration of use, and reasons for discontinuation based on patient's age, race/ethnicity, and sex/gender, and by
clinic and HCP characteristics among study clinics; (2) Explore sustainability of the intervention during an
eight-month follow-up after the stepped-wedge Phase; (3) Investigate facilitators and barriers of PrEP delivery
and experiences with the proposed PrEP intervention through qualitative interviews with HCPs, PrEP
Coordinators, and clinic directors of study clinics. The combination of the PrEP Coordinator plus PrEP-Rx has
the potential to improve all steps of the PrEP continuum and enhance overall care by identifying individuals at
high risk of HIV acquisition, standardizing HIV risk assessment, helping in PrEP initiation, systematizing follow-
up visits or laboratory assessments, and educating HCPs about emerging PrEP data. These goals can have a
significant public health impact and be attained with minimal burden on existing clinic resources. We are using
innovative approaches for PrEP delivery which will result in training of HCPs to increase the number of HCPs
capable of offering PrEP. Ultimately, the proposed research has the potential to reduce gaps in the PrEP
cascade.

## Key facts

- **NIH application ID:** 10406498
- **Project number:** 3R01NR017573-04S2
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Parya Saberi
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $161,498
- **Award type:** 3
- **Project period:** 2017-09-20 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10406498

## Citation

> US National Institutes of Health, RePORTER application 10406498, Improving the HIV PrEP Cascade using an Intervention for Healthcare Providers (3R01NR017573-04S2). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10406498. Licensed CC0.

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