# PrEP 4 Her: Developing a Novel Strategy to Implement PrEP into Women's Healthcare

> **NIH NIH R34** · UNIVERSITY OF ALABAMA AT BIRMINGHAM · 2023 · $257,222

## Abstract

PROJECT SUMMARY
HIV disproportionately affects Black cis-gender women, especially in the Southern United States (US). HIV pre-
exposure prophylaxis (PrEP) was approved by the FDA in 2012 and is an effective prevention tool able to
decrease HIV transmission up to 92% among cis-gender women. However, there has been minimal PrEP uptake
among racial minority groups and inequitable utilization in the South. With implementation of behavioral
interventions, primarily focused on demand creation (i.e. community distribution, scheduling PrEP appointments
during events celebrating gay pride, etc.), PrEP utilization among almost all groups except Black cis-gender
women has improved. Given these inequities, there is an urgent need to better understand how to improve PrEP
utilization among Black cis-gender women in geographic locations with the greatest need, like the South. Black
cis-gender women have significant individual-level barriers to PrEP utilization, including but not limited to low
HIV/PrEP knowledge, PrEP stigma, and low perceived need. Programs to implement PrEP in Title X family
planning clinics, where cis-gender women already receive routine care, provide attractive venues to improve
access. However, in PrEP implementation studies at these clinic sites, while improvement in provider-knowledge
and PrEP referrals occurred, PrEP uptake was still low when on-site services were not available. While more
research is needed to improve PrEP access in family planning clinics that specialize in women’s healthcare, in
states like Alabama, where clinics receiving Title X funding are currently not providing PrEP services, additional
strategies are needed. Gynecology clinics offer an ideal setting for PrEP care as a part of routine reproductive
and sexual health care. Gynecologists already provide primary health care services for many cis-gender women,
oftentimes in place of a primary care provider, making this clinic setting ideal for integration of PrEP services
tailored for Black women. Our implementation study is informed by compelling preliminary data from almost 800
Black cis-gender women living in Alabama using discrete choice experiment methodology, which determined
their desired PrEP services would be delivered in a clinical care setting by a gynecologist, rather than telehealth
or pharmacy based programs. The proposed study will pursue three specific aims: (1) Evaluate key determinants
for implementation of PrEP into gynecology clinic settings through concurrent mixed-methods; (2) Develop and
refine a multi-component implementation strategy to integrate PrEP in routine women’s health visits (i.e.
PrEP4Her) and (3) Pilot PrEP4Her at a gynecology clinic. We will measure implementation outcomes grounded
in the RE-AIM framework, incorporating constructs from Proctor et al, including: reach, efficacy, acceptability,
fidelity, adoption and preliminary effectiveness. Upon completion of our proposed research, our inter-disciplinary
team, which includes expe...

## Key facts

- **NIH application ID:** 10682433
- **Project number:** 5R34MH128002-03
- **Recipient organization:** UNIVERSITY OF ALABAMA AT BIRMINGHAM
- **Principal Investigator:** Latesha Ellen Elopre
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $257,222
- **Award type:** 5
- **Project period:** 2021-08-13 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10682433

## Citation

> US National Institutes of Health, RePORTER application 10682433, PrEP 4 Her: Developing a Novel Strategy to Implement PrEP into Women's Healthcare (5R34MH128002-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10682433. Licensed CC0.

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