# Alignment of PrEP use with HIV risk in young women

> **NIH NIH R21** · UNIVERSITY OF WASHINGTON · 2020 · $229,011

## Abstract

ABSTRACT
Oral pre-exposure prophylaxis (PrEP) is a recommended component of combination HIV prevention by the World
Health Organization and an approved biomedical intervention in many countries. In sub-Saharan Africa, young
women are a priority population for HIV prevention and targeted to initiate PrEP, given the recent high rates of
HIV incidence among women and urgent needs for strategies that do not require the engagement of male
partners. A key question in the field is whether young women initiating PrEP have ongoing HIV risk and
adhere to PrEP sufficiently to have protection from HIV when they have condomless sex with HIV-
infected partners. The primary objective of this proposal is to leverage an existing cohort of young women using
pre-exposure prophylaxis (PrEP) in Uganda to conduct objective measurement of HIV risk and determine
whether women’s use of PrEP aligns with their true risk for acquiring HIV. To achieve our aims, we will collect
samples and conduct laboratory assays to determine whether women in our ongoing cohort have: 1) detectable
Y chromosome DNA (indicating exposure to semen in the past week) and/or 2) infection with common curable
bacterial sexually transmitted infections N. gonorrhoeae or C. trachomatis, either are indications of HIV risk. We
will also initiate recruitment and follow up of young men who are sexual partners of the women to determine
whether the young men are infected with N. gonorrhoeae, C. trachomatis or HIV. We will use novel methods to
recruit young men including the provision of HIV self-test kits through their female partners. These new measures
of HIV risk will be merged with already collected data on tenofovir concentration in blood and daily pill box
openings, objective measures of PrEP use.
We have specified the following aims: 1) To determine whether young women’s adherence to PrEP aligns with
HIV risk using objective measures of PrEP adherence and HIV risk and 2) To determine whether young women’s
adherence to PrEP aligns with the HIV status and risk of their male partners.
Impact. Objective measurement of HIV risk and the engagement of young women’s male partners is the only
true way to know the HIV risk of women. Our study will provide a framework for understanding how and when
young women decide to take PrEP, estimate the proportion of women that are benefitting from HIV protection
when they have male partners with or at high risk of acquiring HIV, and provide novel opportunity to engage
young men in PrEP delivery and as supporters of women’s PrEP use.

## Key facts

- **NIH application ID:** 9925907
- **Project number:** 1R21HD098923-01A1
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Renee A. Heffron
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $229,011
- **Award type:** 1
- **Project period:** 2020-01-07 → 2021-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9925907

## Citation

> US National Institutes of Health, RePORTER application 9925907, Alignment of PrEP use with HIV risk in young women (1R21HD098923-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9925907. Licensed CC0.

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