# Unified Approach to Address PrEP Cascade for BMSM

> **NIH NIH R34** · UNIVERSITY OF CONNECTICUT STORRS · 2020 · $281,750

## Abstract

Biomedical HIV prevention tools are very promising, but are not sufficiently reaching those in greatest need. This
R34 application requests support to develop a novel, unified model to address PrEP interest, uptake, and
adherence among Black men who have sex with men (BMSM). BMSM have experienced elevated rates of HIV
incidence and prevalence since the beginning of the US epidemic, and the CDC estimates that half of BMSM will
be diagnosed with HIV in their lifetime. In our current (non-overlapping) work, we have documented an
exceedingly high 5.1% annual HIV incidence rate and 35% HIV prevalence rate among BMSM (R01MH094230,
N=549). Although Pre-Exposure Prophylaxis (PrEP) is highly effective for preventing HIV, there is urgent need to
improve efforts to deliver PrEP, in particular, for BMSM at-risk for HIV. Current strategies to increase PrEP
interest, uptake, and adherence are not adequate and there are formidable barriers (e.g., stigma surrounding
PrEP use, and adherence and retention concerns) to sufficient coverage of PrEP that must be addressed.
Without considerable and targeted change to our current approach to PrEP delivery, we will fail to adequately
provide PrEP to those in greatest need. In our PrEP focused preliminary studies with BMSM, we have identified
two primary areas in need of critical focus and intervention – (1) stigma related to PrEP use, and (2) medication
cognitions such as the perceived costs and benefits of taking PrEP, both of which can impede PrEP interest,
uptake, and adherence. To address these areas we are proposing to develop an intervention model grounded in
two novel cognitive/behavioral theories: the HIV Stigma Framework and the Medication Necessity-Concerns
Framework. Our proposed study includes: Specific Aim 1: Conduct elicitation research with BMSM, community
advisers, and expert consultants to design an empirically-based PrEP enhancement intervention for use in
targeted service delivery settings. Specific Aim 2: PrEP messaging and intervention content will be assessed
by a community advisory panel, and intervention feasibility and acceptability will be completed by conducting a
pre-pilot test of the intervention procedures. Specific Aim 3: Conduct a pilot test that compares the PrEP
enhancement intervention (N=100), including on-demand interactive text messaging, to a contact matched PrEP
information only and sexual risk counseling control intervention (N=50) at 2, 4, and 6 month follow-ups on PrEP
uptake, adherence, and persistence in order to establish preliminary intervention efficacy.
 Advances in biomedical HIV prevention, such as the availability of PrEP, will only impact the HIV
epidemic if concurrent efforts are made to address the social and behavioral challenges that are associated with
achieving sufficient coverage of PrEP among individuals at elevated risk for HIV. Low-resource burden, easily
implemented, and effective social/behavioral interventions are urgently needed if the full benefits of Pr...

## Key facts

- **NIH application ID:** 9949385
- **Project number:** 5R34MH115798-03
- **Recipient organization:** UNIVERSITY OF CONNECTICUT STORRS
- **Principal Investigator:** Lisa A Eaton
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $281,750
- **Award type:** 5
- **Project period:** 2018-08-01 → 2022-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9949385

## Citation

> US National Institutes of Health, RePORTER application 9949385, Unified Approach to Address PrEP Cascade for BMSM (5R34MH115798-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9949385. Licensed CC0.

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