# PrEP-3D: An Integrated Pharmacy Digital Diary and Delivery Strategy to Increase PrEP Use Among MSM

> **NIH NIH R01** · PUBLIC HEALTH FOUNDATION ENTERPRISES · 2020 · $485,572

## Abstract

Project Summary/Abstract
 Men who have sex with men (MSM) are the population most affected by HIV in the United States,
accounting for over two-thirds of all new HIV diagnoses. Pre-exposure prophylaxis (PrEP) has demonstrated
high levels of efficacy for HIV prevention among MSM, however, discontinuation rates are high and are
emerging as the primary challenge in implementing PrEP. A pharmacy-led model of PrEP delivery, combined
with mobile app-based PrEP support, could address many of the challenges with starting and staying on PrEP,
and also greatly reduce burden on the medical system, as the current requirement for quarterly clinic visits
would require 4.4 million additional medical visits annually. Based on the Information-Motivation-Behavioral
Skills model, we have developed the PrEP-3D intervention, an integrated mobile app to increase PrEP uptake
and persistence among MSM, with key features including 1) a sexual risk score that incorporates the impact of
PrEP use on risk; 2) an integrated sexual and pill-taking diary that provides information on levels of PrEP
protection based on adherence patterns, augmented with pill reminders and motivational badges; 3) an
interactive bi-directional messaging support system with automated check-ins to allow rapid resolution of
issues such as side effects or insurance issues; and 4) integration with an online pharmacy-led PrEP program
that coordinates lab tests and medication refills, provides medication support, and addresses insurance/cost
issues. The effectiveness of this integrated PrEP-3D platform will be compared with clinic-based PrEP
provision among MSM initiating PrEP throughout the San Francisco Bay Area (SFBA), a highly diverse region
ranking 2nd in the number of new HIV diagnoses in California. In aim 1, PrEP-3D will be refined through
iterative focus groups with 32-40 MSM, followed by optimization of the intervention in a 3-month technical pilot
among 30 MSM, 10 of whom will be Spanish-speaking. In aim 2, we will conduct a randomized controlled trial
to evaluate the effectiveness of PrEP-3D in improving PrEP initiation and persistence in the SFBA. In this trial,
we will enroll 150 at-risk MSM interested in starting PrEP who will be randomized 2:1 to PrEP-3D (N=100) or a
standard of care control condition (clinic-based PrEP delivery) (N=50) and assess tenofovir-diphosphate (TFV-
DP) levels in dried blood spots at 3, 6, 9, and 12 months as our primary outcome measure. In aim 3, we will
assess cost and cost-effectiveness of PrEP-3D vs. clinic-based PrEP delivery. To ensure inclusion of those
disproportionately impacted by HIV in the SFBA, we will enroll at least 50% Black and Latino and 50% under
age 35. These studies will test the hypotheses that the PrEP-3D intervention will be more effective than clinic-
based PrEP delivery in increasing PrEP uptake and persistence among MSM, and can serve as a scalable
model for expanding PrEP services and support to vulnerable populations nationwide.

## Key facts

- **NIH application ID:** 9910448
- **Project number:** 5R01MH119956-02
- **Recipient organization:** PUBLIC HEALTH FOUNDATION ENTERPRISES
- **Principal Investigator:** Susan Buchbinder
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $485,572
- **Award type:** 5
- **Project period:** 2019-04-08 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9910448

## Citation

> US National Institutes of Health, RePORTER application 9910448, PrEP-3D: An Integrated Pharmacy Digital Diary and Delivery Strategy to Increase PrEP Use Among MSM (5R01MH119956-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9910448. Licensed CC0.

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