# A Reinforcement Intervention for Increasing HIV Testing Among At-Risk Women

> **NIH NIH R01** · UNIVERSITY OF CONNECTICUT SCH OF MED/DNT · 2020 · $561,656

## Abstract

Abstract
 African American and Latina women, as well as women living in poverty, are at disproportionate risk for
contracting HIV (CDC, 2018). Prevalence is increased further in these women if they have other risk factors for
HIV, including substance use, history of intimate partner violence, and homelessness. Despite the relatively
high prevalence rates in these populations, many women with these characteristics have never been tested for
HIV (CDC, 2016a). Knowledge of one’s HIV status is crucial for rapid access to treatment and reducing the
spread of HIV. Thus, effective interventions for enhancing testing in these women are an imminent need.
 Reinforcement interventions can be efficacious in enhancing testing, and our NIH-funded study in
Canada (Hull et al., 2013) found that rates of successful testing in high risk adults increased from 11% to 83%
when reinforcers were provided. In the proposed project, we will evaluate a systems approach applying a
similar intervention for enhancing HIV testing in high risk women. We will train ~50 staff from multiple
community agencies that provide services to high risk women to encourage HIV testing and deliver
reinforcement for testing. After staff training, 334 women recruited at these community agencies will be
randomized to standard care referral procedures plus HIV risk reduction education or the same plus
reinforcement, in which they can receive up to $40 for completing HIV testing at study initiation and for repeat
testing 6 and 12 months later. Primary systems outcomes will include staff knowledge and attitudes about HIV
testing and reinforcement interventions. The primary client outcome will be proportions who undergo testing.
Exploratory analyses will evaluate moderators of testing, including clinic, clinician, and client characteristics, as
well as indices of change in sexual risk and other behaviors over time and by condition over time. We will also
estimate costs of the intervention and its cost effectiveness in promoting HIV testing.
 This project evaluates new models to promote HIV testing. It institutes trainings and provides direct
resources for integrating reinforcement-based HIV testing referral procedures to women accessing services at
substance abuse treatment clinics, Federally Qualified Heath Centers, domestic violence agencies, and
homeless shelters. Trainings address systemic and structural issues and provide concrete methods and
resources to enhance testing (i.e., reinforcers). Our experiences integrating reinforcement for substance use
treatment through the Veterans Administration (VA) speak directly to this project’s potential success, with over
90% of VA clinics implementing reinforcers after training (DePhillipis et al., in press; Petry et al., 2014a). Due to
this success, the VA has committed to supporting this intervention indefinitely. This project likewise proposes
to initially provide reinforcers with the presumption that, if effective, costs will be justified by HIV test...

## Key facts

- **NIH application ID:** 9929454
- **Project number:** 5R01MD013550-03
- **Recipient organization:** UNIVERSITY OF CONNECTICUT SCH OF MED/DNT
- **Principal Investigator:** Kristyn Zajac
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $561,656
- **Award type:** 5
- **Project period:** 2018-09-01 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9929454

## Citation

> US National Institutes of Health, RePORTER application 9929454, A Reinforcement Intervention for Increasing HIV Testing Among At-Risk Women (5R01MD013550-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9929454. Licensed CC0.

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