# Optimizing Adherence to PrEP among Young African Women through a Community Adherence Club Intervention

> **NIH NIH K23** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2020 · $199,044

## Abstract

PROJECT SUMMARY/ABSTRACT
Adolescent girls and young women (ages 15-24 years) have among the highest HIV incidence rates in sub-
Saharan Africa. Pre-exposure prophylaxis (PrEP) has the potential to dramatically reduce new HIV infections in
this population. However, in several PrEP trials conducted among women in Africa, adherence was too low to
result in effectiveness. Substantial knowledge gaps on the drivers of, and how to optimize, adherence to PrEP
must therefore be addressed in order to harness the promise of PrEP for young women. The proposed training
and research plan in this K23 Mentored Patient-Oriented Research Career Development Award application will
allow Catherine Koss, MD to acquire the necessary skills to achieve her career goal of becoming an NIH-
funded clinical investigator with expertise in designing and testing HIV prevention interventions, with an
emphasis on adherence interventions for women. In this K23 proposal, under the guidance of an expert and
dedicated mentoring team, Dr. Koss will use a mixed methods approach to test the central hypothesis that an
intervention building on the community adherence club model and tailored to the health needs and priorities of
young women will be feasible, acceptable, and ultimately increase adherence to PrEP among young women in
East Africa. The community adherence club strategy, in which patients attend group visits led by a health care
worker for medication provision and adherence support, is being successfully used in HIV treatment (including
among youth) to increase rates of retention in care and viral suppression, but has not yet been adapted for
PrEP delivery. This proposal will leverage the resources of an ongoing population-based study that has
enrolled over 320,000 individuals in 32 communities in rural Kenya and Uganda to test HIV treatment and
prevention strategies (SEARCH, NCT01864603, PI Havlir, K23 primary mentor). SEARCH will provide oral
PrEP with tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) to 6,400 women and men who will be followed
at quarterly study visits for monitoring and adherence assessment via objective biological measures (tenofovir
concentrations in hair and plasma) and self-report. Building on the candidate's prior research on PrEP and
adherence in women, this proposal will address the following specific aims: (1) to elucidate factors influencing
adherence to PrEP among young women receiving PrEP in community-based settings in East Africa; (2) to
develop a community adherence club intervention to increase adherence to PrEP among young women; (3) to
evaluate the feasibility, acceptability, and preliminary effectiveness of the adherence club intervention among
young women on PrEP. The proposed research is based on principles of differentiated service delivery and is
aligned with Dr. Koss' career development plan to gain expertise in qualitative and mixed methods research
and intervention development, testing, and evaluation. The findings of this propo...

## Key facts

- **NIH application ID:** 9933090
- **Project number:** 5K23MH114760-03
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Catherine Anne Stimets Koss
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $199,044
- **Award type:** 5
- **Project period:** 2018-06-15 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9933090

## Citation

> US National Institutes of Health, RePORTER application 9933090, Optimizing Adherence to PrEP among Young African Women through a Community Adherence Club Intervention (5K23MH114760-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9933090. Licensed CC0.

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