# Reducing psychological barriers to PrEP persistence among pregnant and postpartum women in Cape Town, South Africa

> **NIH NIH K23** · BOSTON UNIVERSITY (CHARLES RIVER CAMPUS) · 2022 · $188,665

## Abstract

Background: Pregnant women in South Africa (SA) are at high risk of HIV acquisition. Pre-exposure prophylaxis
(PrEP) use during pregnancy is both safe and effective in preventing HIV. However, posttraumatic stress
(associated with intimate partner violence and/or other traumas) and depression negatively impact PrEP
adherence among women in SA. Addressing posttraumatic stress and depression will likely improve PrEP
adherence and persistence (i.e., sustained PrEP adherence over time) during pregnancy and breastfeeding,
which are periods of dramatically increased HIV risk. The overarching goal of this proposal is to develop and test
the feasibility and acceptability of a cognitive behavioral intervention that targets common underlying factors of
posttraumatic stress and depression to improve PrEP adherence and persistence during pregnancy and the
postpartum transition. Candidate: I am a clinical psychologist and a postdoctoral fellow at Massachusetts
General Hospital/Harvard Medical School. I am applying for a five-year K23 Career Development Award to obtain
the training, mentorship, and research experience that will enable me to become (1) an independent investigator
at the R01 level and (2) an expert in reducing the psychological barriers to HIV prevention among women in low-
resource settings. Mentoring: Dr. Conall O’Cleirigh will serve as my primary mentor; he brings expertise in the
psychosocial aspects of HIV prevention and intervention development for global contexts. Drs. Christina Psaros
and Jessica Haberer, both co-mentors, will offer guidance on qualitative data analysis as it applies to intervention
development and implementation science frameworks for low- and middle-income settings. Drs. Landon Myer,
John Joska, and Lucia Knight, my SA-based co-mentors, will provide mentorship on biomedical HIV prevention
strategies for use during pregnancy/postpartum, intervention development for the South African context, and
intervention sustainability within the antenatal clinic setting. Dr. Robert Parker, a biostatistician, will serve as a
consultant. Training: Specific training in qualitative analysis for intervention development and implementation,
HIV prevention during pregnancy, and psychosocial treatment development for resource-limited settings will be
achieved through intensive direct mentorship, coursework, workshops, and primary research in SA. This training
and research experience will enable me to support the mental and sexual health of women at risk for acquiring
HIV. Research: The specific aims of the project are to (1) explore the mechanisms by which posttraumatic stress
and depression impact PrEP adherence and persistence during pregnancy via qualitative interviews; (2) develop
and conduct a proof-of-concept test of a brief PrEP adherence and persistence intervention that reduces the
negative impact of psychological mechanisms common to posttraumatic stress and depression on PrEP use,
and builds behavioral skills to improve self-car...

## Key facts

- **NIH application ID:** 10545303
- **Project number:** 1K23MH131438-01
- **Recipient organization:** BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
- **Principal Investigator:** Amelia M. Stanton
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $188,665
- **Award type:** 1
- **Project period:** 2022-08-05 → 2027-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10545303

## Citation

> US National Institutes of Health, RePORTER application 10545303, Reducing psychological barriers to PrEP persistence among pregnant and postpartum women in Cape Town, South Africa (1K23MH131438-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10545303. Licensed CC0.

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