# An Interactive Systems Approach to Ending the HIV Epidemic Among Women in Atlanta

> **NIH NIH R01** · EMORY UNIVERSITY · 2022 · $662,241

## Abstract

ABSTRACT
Supply and demand constraints have affected PrEP scale-up for cisgender women in the Southern US. PrEP
use requires ensuring that cisgender women who can benefit from PrEP are aware of it (i.e., demand side) and
ensuring PrEP is accessible in settings where cisgender women seek care (i.e., supply side). Anchoring PrEP
care to Title X-funded family planning services that cisgender women already trust, access routinely, and deem
useful for their sexual health is of great appeal, as it offers an ideal opportunity to reach women who may
benefit from PrEP. In Georgia, the state with the highest rate of new HIV diagnoses, our work demonstrates
that many Title X family planning clinics do not provide PrEP. Our research also shows low PrEP awareness
and use among Atlanta cisgender women. Further, our Atlanta-based family planning-focused PrEP
implementation research indicates that even when FP clinics offer PrEP, few cisgender women uptake PrEP,
and providers note continued discomfort with screening, recommending and counseling about PrEP. Lessons
learned from HPV vaccine and contraception rollout demonstrates that awareness and availability alone may
not be sufficient; moving cisgender women from PrEP awareness to uptake demands alternative delivery
models, inclusive of women's perspectives, to overcome other factors impeding women from using PrEP.
Improving PrEP reach among cisgender women may therefore require more effectively engaging them in the
development of appropriated and acceptable patient-centered PrEP care approaches to support uptake. In the
proposed project, we will (Aim 1) use the Interactive Systems Framework to employ tailored implementation
strategies informed by our extensive prior work to support PrEP adoption and implementation across Atlanta
Title X clinics (addressing supply-side barriers); (Aim 2) use an evidence-based Community Organizing
Approach to raise awareness, interest, and connection to PrEP among cisgender women (addressing demand-
side barriers); and (Aim 3) innovatively use human centered design (HCD), a patient-centered methodology
that brings bringing end-users and developers together to co-create care delivery strategies, to bring Southern
women's voices into the development of PrEP care delivery strategies. Given limited research pertaining to
strategies to increase PrEP reach among cisgender women in the South, findings from each aim will
independently fill numerous gaps for optimizing clinic and community strategies to strengthen HIV prevention
for Southern women. Given our collaboration with Georgia Family Planning System (Georgia's Title X grantee),
Atlanta area Title X clinics, and robust partnerships with sexual health CBOs (led by SisterLove), we are
uniquely positioned to mount a coordinated approach across diverse Atlanta counties built around our clinic-
academic-CBO collaboration to strengthen HIV prevention for women, and importantly, to create a sustainable
systems approach to move new HIV pr...

## Key facts

- **NIH application ID:** 10474558
- **Project number:** 5R01MH128045-02
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** JESSICA A SALES
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $662,241
- **Award type:** 5
- **Project period:** 2021-09-01 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10474558

## Citation

> US National Institutes of Health, RePORTER application 10474558, An Interactive Systems Approach to Ending the HIV Epidemic Among Women in Atlanta (5R01MH128045-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10474558. Licensed CC0.

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