# The Southern Pre-Exposure Prophylaxis Cohort Study: Longitudinal PrEP Initiation and Adherence among Parolees

> **NIH NIH R01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2020 · $528,208

## Abstract

PROJECT ABSTRACT
The estimated HIV prevalence among criminal justice (CJ) involved individuals is three times higher than
the general population. Parolees on post-release supervision after release experience multi-level obstacles
(e.g., lack of access to housing, employment) that act as barriers to HIV prevention efforts, making existing
approaches to HIV prevention insufficient for reducing HIV incidence. Pre-exposure prophylaxis (PrEP) is a
once daily medication (emtricitabine/tenofovir, FTC/TDF) that has demonstrated efficacy in preventing HIV
among at-risk groups. Little is known about PrEP knowledge, acceptability, initiation, and sustained use
among parolees recently released from prison or how these patterns vary by individual (HIV risk factor,
sociodemographic characteristics), social (stigma, social support), and structural (housing, employment)
factors. Therefore, we propose to conduct an observational, multi-site cohort study in North Carolina,
Kentucky, and Florida—the Southern Pre-Exposure Prophylaxis [PrEP] Cohort Study among Parolees
(SPECS-P). This study is guided by the Social Ecological Model and the NIMHD Minority Health and Health
Disparities Research Framework, which both have a focus extending beyond the individual and
acknowledge that multi-level (individual, social, and structural) factors play a role in the perpetuation of
persistent health disparities. The specific aims of the proposed study are: 1) characterize PrEP knowledge
and acceptability among parolees; 2) identify the multi-level factors that predict PrEP initiation and sustained
use among parolees; 3) qualitatively assess the multi-level factors that affect PrEP acceptability, initiation
and sustained use to inform future intervention development. The proposed project will be the first
observational cohort study that includes a CJ involved population at extreme risk for HIV acquisition. Our
study is aligned with the following high priority topics as defined by the NIH, NIMHD Science Visioning, and
Office of AIDS Research: a) advancing evaluation of approaches to improve minority health or to reduce
health disparities; and b) reducing incidence of HIV/AIDS and implementing strategies to improve entry into
prevention services.

## Key facts

- **NIH application ID:** 9892887
- **Project number:** 5R01MD013573-03
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Lauren Brinkley-Rubinstein
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $528,208
- **Award type:** 5
- **Project period:** 2018-09-01 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9892887

## Citation

> US National Institutes of Health, RePORTER application 9892887, The Southern Pre-Exposure Prophylaxis Cohort Study: Longitudinal PrEP Initiation and Adherence among Parolees (5R01MD013573-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9892887. Licensed CC0.

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