# Development and Evaluation of a PrEP Decision Aid for Women Seeking Domestic Violence Services in Baltimore

> **NIH NIH R34** · JOHNS HOPKINS UNIVERSITY · 2022 · $247,100

## Abstract

HIV and intimate partner violence (IPV) are intersecting, mutually-reinforcing epidemics that significantly affect
Black women, particularly in the U.S. South. IPV escalates heterosexual transmission of HIV. IPV-exposed
women are four-times more likely to be infected with HIV than their counterparts. IPV-exposed women are at
greater risk for HIV infection due to forced and coerced sex with partners with HIV, condomless sex, enduring
fear of safe sex (condom) negotiations and substance use. Male IPV perpetrators are more likely to have
untreated HIV, directly increasing women’s HIV risk. In response to the intersection of HIV and IPV among U.S.
women, the 2020 National HIV/AIDS Strategy calls for initiatives that “expand public outreach, education, and
prevention efforts on HIV and other intersecting issues such as IPV.” The Ending the HIV Epidemic (EHE) Plan
further emphasizes the need to increase HIV prevention in areas with high HIV burden, and there is an
opportunity to increase uptake of partner-independent HIV prevention among IPV-exposed Black women in
these areas. Pre-exposure prophylaxis (PrEP) is a user-controlled, effective HIV prevention strategy for IPV-
exposed Black women, but national data indicates that PrEP is severely underutilized by women compared to
men. The CDC has outlined two challenges to PrEP implementation for women: (1) women’s accurate
assessment of their personal and partners’ HIV risk; and (2) few settings offer PrEP introductions. Informed
decision aids can overcome these obstacles because they are patient-centered interventions that can increase
PrEP awareness, reorient personal risk estimation, and empower women to make informed, values-based
decisions. A PrEP decision aid in domestic violence (DV) agencies could address these PrEP implementation
challenges. Our Type II hybrid effectiveness-implementation study seeks to adapt an existing PrEP decision aid
to IPV-exposed Black women seeking DV services in Baltimore, Maryland, an EHE priority area. Self- and
advocate-administered versions of the PrEP decision aid will be implemented and the aid will be evaluated using
a two-arm randomized trial, guided by the Consolidated Framework for Implementation Research (CFIR). A
formative evaluation using qualitative interviews with IPV-exposed Black women (N=20) and DV advocates
(N=10) will be conducted to adapt the existing PrEP decision aid. Next, the decision aid will be implemented in
a DV agency and 60 IPV-exposed Black women will be randomized to either the self- or advocate-administered
versions of the aid to compare feasibility, acceptability and preliminary effectiveness at PrEP uptake with
baseline, 1-, 3-, and 6-month surveys. Focus groups with DV advocates will assess for implementation process
outcomes. This study will: provide support for a PrEP decision aid that addresses HIV prevention for the key
population of IPV-exposed Black women; use implementation science to increase PrEP uptake in the geographic
prio...

## Key facts

- **NIH application ID:** 10468296
- **Project number:** 5R34MH127986-02
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Jaimie Meyer
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $247,100
- **Award type:** 5
- **Project period:** 2021-08-11 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10468296

## Citation

> US National Institutes of Health, RePORTER application 10468296, Development and Evaluation of a PrEP Decision Aid for Women Seeking Domestic Violence Services in Baltimore (5R34MH127986-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10468296. Licensed CC0.

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