# kINSHIP: Peer navigators addressing INtersectional Stigma to improve HIV Prevention among criminal-justice involved women

> **NIH NIH R34** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2020 · $161,334

## Abstract

Project Summary/Abstract
Stigma persists as a principle factor shaping HIV risk. Women involved in the criminal justice system have
complex and highly stigmatized sexual and substance use risk profiles and are particularly vulnerable to, and
experience, high rates of HIV. Pre-exposure prophylaxis, or PrEP, is an efficacious HIV prevention strategy,
however, women at high-risk of HIV infection in the United States (US) are largely absent from national efforts
to improve PrEP awareness and uptake. Criminal justice settings represent an important opportunity to address
disparities in HIV by linking high-risk women, who experience multiple, intersecting stigmas with innovative
biomedical HIV prevention strategies, like PrEP. Peer-led patient navigation interventions have demonstrated
efficacy in building trust and reducing stigma and discrimination-related barriers to healthcare engagement, and
hold strong potential to address multiple, intersecting stigmas and other multifactorial and complex barriers to
PrEP acceptability, linkage, and uptake for criminal justice involved women. As a multidisciplinary team with
expertise in HIV clinical medicine and care cascade research, intersectionality, stigma, and behavioral health
(substance use, mental health and HIV prevention) interventions for justice-involved populations, we propose to
develop and test a peer-led patient navigator PrEP linkage intervention for women at risk for HIV acquisition
who are on probation in San Francisco. Intervention development and study design will be guided by our
team's pilot research, the Stigma and HIV Disparities Framework, and the PrEP Continuum of Care model.
Study aims are to: 1) Determine the content and structure of a peer-led PrEP screening and linkage navigation
intervention (Project kINSHIP) for high-risk CJI-women; 2) Refine and test the content and structure of the
kINSHIP intervention for criminal justice involved women; and 3) Assess the feasibility, acceptability, and
preliminary impact of the kINSHIP intervention on internalized stigma and the PrEP continuum of care in a pilot
randomized trial. Formative qualitative work with key stakeholders, including women on probation, probation
staff, and medical/public health staff in Aim 1 will guide intervention development and testing in Aim 2. In Aim 3,
we will examine the primary outcome of PrEP service linkage and secondary outcomes such as time to linkage,
PrEP prescription/initiation, and PrEP adherence/persistence. We will explore how intersectional stigma may
moderate intervention effects on linkage to PrEP. The proposed study has the potential to: 1) reduce the impact
of intersectional stigma as a barrier to service care engagement, 2) inform PrEP care continuum estimates for
criminal justice-involved women as well as identify barriers, and 3) create an intervention suitable for large-scale
efficacy testing and translation to other criminal justice settings.

## Key facts

- **NIH application ID:** 9926752
- **Project number:** 1R34DA050480-01
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Emily F Dauria
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $161,334
- **Award type:** 1
- **Project period:** 2020-05-15 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9926752

## Citation

> US National Institutes of Health, RePORTER application 9926752, kINSHIP: Peer navigators addressing INtersectional Stigma to improve HIV Prevention among criminal-justice involved women (1R34DA050480-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9926752. Licensed CC0.

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