# Improving HIV Prevention Services among Socioeconomically Disadvantaged Cis-gender Women

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2024 · $786,802

## Abstract

ABSTRACT
Nearly one out of five new HIV infections in the United States occurs among cisgender women, with 85% of
cases attributed to heterosexual contact. Black women are disproportionately affected, comprising 60% of new
HIV infections among women, although they comprise only 14% of the female population. Consistent condom
use, daily oral tenofovir disoproxil fumarate 300mg-emtricitabine 200mg (TDF-FTC) as pre-exposure prophylaxis
(PrEP), and male partner HIV testing are evidence-based interventions for women to reduce their risk of HIV
acquisition. Yet, only 1-6% of women who could benefit from PrEP are prescribed it. Barriers to PrEP uptake are
multifactorial. Patient-level barriers to PrEP uptake include women who may not think PrEP is for them, given
that the majority of PrEP clinical trials and marketing strategies have targeted men who have sex with men. Also,
cisgender women may not perceive themselves as being at risk for HIV. Further exacerbating the discordance
between risk perception and actual risk is that women tend to be unaware of their male partners' HIV serostatus
and HIV risk factors. Provider-level barriers include difficulty identifying patients at high risk for HIV, discomfort
with sexual history taking, and lack of PrEP knowledge. Unfortunately, an accurate HIV risk assessment tool
does not exist for U.S. cisgender women and may not ever exist because the HIV incidence in U.S. women is
too low to develop it. An alternative evidence-based intervention is desperately needed. We plan to fill this gap
by identifying an effective intervention and implementation strategy to increase PrEP uptake in an ObGyn clinical
setting (where women receive prenatal care and sexual and reproductive health services). Since TDF-FTC was
approved, women have consistently expressed a preference for receiving HIV prevention services in clinics
where they receive ObGyn care. Our multi-level (patient and provider-level), multi-component intervention
includes EHR data collection and education using multi-media tools. Our central hypothesis is that
communicating tailored HIV risk messaging in real-time in a relatable and comprehensive manner to patients
and ObGyn providers can increase conversations about HIV prevention. Aim 1A: To determine the most
effective intervention and evaluate its implementation in an ObGyn clinical setting. 1B: To identify modifiable
contextual factors associated with effective implementation using the RE-AIM framework. Aim 2: To evaluate
the cost-effectiveness, return on investment, budget impact, and equity impact of the multi-level intervention
components and the implementation strategy. In collaboration with our local government- and a HRSA-funded
implementing partner sites, we hope to demonstrate a sustainable and scalable solution to increasing PrEP
counseling by ObGyn providers and PrEP uptake by patients.

## Key facts

- **NIH application ID:** 10885953
- **Project number:** 5R01MH132146-03
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Jenell S Coleman
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $786,802
- **Award type:** 5
- **Project period:** 2022-08-05 → 2027-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10885953

## Citation

> US National Institutes of Health, RePORTER application 10885953, Improving HIV Prevention Services among Socioeconomically Disadvantaged Cis-gender Women (5R01MH132146-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10885953. Licensed CC0.

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