# Improving Choice and Use of Biomedical HIV Prevention for Women in Uganda: A Couples-Based Approach

> **NIH NIH R01** · RESEARCH TRIANGLE INSTITUTE · 2024 · $783,113

## Abstract

PROJECT SUMMARY/ABSTRACT
 The HIV prevention field has realized a long-sought goal to have multiple safe and effective HIV
prevention options that offer women the opportunity to choose a pre-exposure prophylaxis (PrEP) product
that best fits their needs and preferences. Product attributes across injectable long-acting cabotegravir,
dapivirine vaginal ring, and oral PrEP differ considerably, with implications for user experience, adherence
requirements, and discreetness. Clinical trials and demonstration projects have highlighted challenges in
achieving sustained PrEP use, and decades of research in sub-Saharan Africa (SSA) have underscored the
significant role that male partners play in many women’s choice of and ability to consistently use these
methods. Although it remains critically important to center women’s agency in choosing options that meet
their needs, many women want to involve their partners in these decisions and, in many settings, men
influence women’s ability and enable their autonomy to adopt and use prevention effectively. The overall goal
of this study is to evaluate the effectiveness and implementation of a couples-based shared decision-making
intervention called CUPID (Couples United in HIV Prevention Informed Decisions) within the CATALYST
demonstration project in Uganda that offers choice in biomedical PrEP to women. The CUPID intervention
will involve delivery of a paper-based, shared decision-making tool in community and clinic settings by peer
PrEP ambassadors affiliated with Ministry of Health facilities. CUPID aims to influence multiple PrEP
outcomes (uptake, persistence and adherence) through couples’ shared decision making to improve
communication about HIV prevention and PrEP options, mutual commitment to HIV prevention within the
relationship, and partner support for PrEP use.
 We will accomplish this by conducting a hybrid type 1 effectiveness-implementation study designed to
refine the CUPID intervention for use in public health settings (Aim 1), evaluate its effectiveness in improving
PrEP uptake, persistence, and use among Ugandan women (Aim 2), and assess implementation outcomes
to inform the adoption and integration of CUPID to support women's PrEP uptake and use (Aim 3). CUPID’s
effectiveness in increasing PrEP use by women will be assessed using a multiple baseline interrupted time-
series design with randomization of health facilities to intervention start time. Implementation outcomes will
assess the acceptability, adoption, feasibility, and fidelity of CUPID using a mixed methods design.
 The study leverages a real-world implementation partnership with the CATALYST study and the Ugandan
Ministry of Health to address the critical question of whether CUPID can optimize women’s PrEP choice and
use through male partner support and shared decision-making using a scalable intervention approach. If
successful, CUPID will offer a community-based strategy for engaging male partners to support PrEP choice
and impro...

## Key facts

- **NIH application ID:** 10990816
- **Project number:** 1R01MH137873-01
- **Recipient organization:** RESEARCH TRIANGLE INSTITUTE
- **Principal Investigator:** Carolyne Akello
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $783,113
- **Award type:** 1
- **Project period:** 2024-09-17 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10990816

## Citation

> US National Institutes of Health, RePORTER application 10990816, Improving Choice and Use of Biomedical HIV Prevention for Women in Uganda: A Couples-Based Approach (1R01MH137873-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10990816. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*