# Behavioral Health Determinants of Adherence in Women Living with HIV

> **NIH NIH K23** · MEDSTAR HEALTH RESEARCH INSTITUTE · 2020 · $184,572

## Abstract

PROJECT SUMMARY
Antiretroviral therapy (ART) adherence and retention in care are critically important and poorly understood
challenges in the care of women living with HIV in the United States. Postpartum attrition and ART non-
adherence leave women with HIV at risk for life-threatening medical complications of immunocompromise and
unplanned and not-medically-optimized pregnancies with greater risk of mother-to-child transmission. The
long-term objective of this proposal is to improve adherence and retention in care for women living with HIV.
To achieve this objective, we propose a prospective, cohort study of women with HIV during pregnancy and
postpartum to 1) adapt an objective ART adherence measure in each trimester and postpartum, 2)
characterize the behavioral health predictors of postpartum ART adherence and retention in care, and 3)
inform the feasibility and design of future research on behavioral health interventions to improve adherence
and retention in care. Our proposal's goals match the National Institute of Mental Health Division of AIDS
Research high research priority “to develop and test interventions to improve HIV treatment outcomes
through optimal treatment adherence and sustained engagement in care”. Our specific aims are to: 1: Adapt
and apply the TDF adherence instrument in each trimester of pregnancy and postpartum and test the
hypothesis that adherence concentration benchmarks will be lower in the 2nd and 3rd trimesters of pregnancy
and immediately postpartum, normalizing in the postpartum period. 2: Test the hypothesis that trauma-related
behavioral health indicators are predictive of postpartum adherence and retention in care, through
administration of a battery of behavioral health measures (depression, PTSD, anxiety) during pregnancy and
examining associations with postpartum adherence and retention in care.
My long-term career goal is to establish an interdisciplinary independent research career focused on
improving the medical care and clinical outcomes of women living with HIV during pregnancy and beyond. The
training aspect of the grant will focus on a combination of didactic course work and experiential learning to
achieve my career development objectives: expertise in 1) pharmacology, namely pharmacokinetic research
and data analysis, and 2) behavioral health, specifically mental health topics pertaining to trauma, HIV and
pregnancy/postpartum, and 3) implementation of clinical and behavioral health randomized controlled trials.
The academic environment, institutional support, and exceptional resources collectively provided by the Mid-
Atlantic CFAR consortium, MedStar Health, and Johns Hopkins University provide an ideal opportunity for
growth as an investigator. This integrated, comprehensive combination of research experience combined with
intensive mentoring, didactic coursework, and participation in a community of learners will directly advance my
career development objectives and provide me with the necess...

## Key facts

- **NIH application ID:** 9921487
- **Project number:** 5K23MH116814-03
- **Recipient organization:** MEDSTAR HEALTH RESEARCH INSTITUTE
- **Principal Investigator:** Rachel K Scott
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $184,572
- **Award type:** 5
- **Project period:** 2018-05-25 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9921487

## Citation

> US National Institutes of Health, RePORTER application 9921487, Behavioral Health Determinants of Adherence in Women Living with HIV (5K23MH116814-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9921487. Licensed CC0.

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