# Informing and promoting Shared decision making for HIV Prevention and Alcohol Reduction: Engaging Diverse Veterans to Refine and Pilot a Decision Aid (SHARE Study)

> **NIH NIH R34** · UNIVERSITY OF WASHINGTON · 2022 · $244,013

## Abstract

ABSTRACT
Preventing HIV transmission with enhanced Pre-exposure Prophylaxis (PrEP) access, particularly among
marginalized populations with disproportionate HIV incidence (e.g., minoritized racial/ethnic and sexual
orientation and gender groups), is a crucial step in ending the HIV epidemic. Though unhealthy alcohol use is a
central modifiable risk factor for HIV incidence and over-represented among marginalized populations, few HIV
prevention interventions exist that synergistically address both unhealthy alcohol use and PrEP. Research is
needed to understand PrEP uptake among individuals with unhealthy alcohol use and to develop scalable
patient-centered interventions that synergistically address unhealthy alcohol use and HIV. The Veterans Health
administration (VA) is a leader in provision of evidence-based care for unhealthy alcohol use, yet substantial
gaps in PrEP implementation for Veterans with unhealthy alcohol use exist—our preliminary research suggests
major gaps in PrEP knowledge, use, and reach, and Veterans with unhealthy alcohol use. Evidence-based
interventions/treatments are available for unhealthy alcohol use, but alcohol use is historically under targeted in
HIV prevention interventions. Our team of interdisciplinary experts in HIV and addiction medicine, the intersection
of alcohol use and HIV, implementation science, health disparities research, and community-partnered research
will use sequential mixed methods guided by socioecological theory, the Consolidated Framework for
Implementation Science, and the Discover/Design/Build/Test (DDBT) process to understand the impact of
unhealthy alcohol use on the PrEP care continuum and then refine an existing decision aid to increase PrEP
initiation in primary care at the point of alcohol-related care in the VA. Quantitative work will include ~1.9 million
individuals, including adequate numbers of minoritized patients (e.g., ~115,000 individuals with minoritized
sexual orientation and ~11,000 individuals with minoritized gender identity) and will assess variation in patterns
of PrEP initiation and persistence across VA facilities and patient subgroups (Aim 1). Findings will be used to
inform purposive sampling for qualitative work to refine (Aim 2) and then pilot test an existing decision aid for
developed previously with NIAAA support (Aim 3). Our study is patient-centered and innovative in characterizing
PrEP care overall and within diverse subgroups of patients with and without unhealthy alcohol use, leveraging a
novel natural language processing (NLP)--driven algorithm for identifying sexual minority groups, and tailoring
an existing decision aid to facilitate shared decision-making for co-occurring HIV prevention and alcohol use.
Study activities will be conducted with iterative input from a community advisory board. The study is highly
responsive to NIAAA priorities and has potential for high impact as it will lay foundation for integrating a patient-
centered and multi-targeted...

## Key facts

- **NIH application ID:** 10540922
- **Project number:** 1R34AA030449-01
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** E. Jennifer Edelman
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $244,013
- **Award type:** 1
- **Project period:** 2022-09-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10540922

## Citation

> US National Institutes of Health, RePORTER application 10540922, Informing and promoting Shared decision making for HIV Prevention and Alcohol Reduction: Engaging Diverse Veterans to Refine and Pilot a Decision Aid (SHARE Study) (1R34AA030449-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10540922. Licensed CC0.

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