A Multi-Level Trauma-Informed Approach to Increase HIV Pre-exposure Prophylaxis Initiation Among Black Women

Johns Hopkins Bloomberg School of Public Health300 enrolled

Overview

U.S. epidemiological data indicates that Black women are a high-risk HIV disparity group, yet initiation of novel prevention strategies like pre-exposure prophylaxis (PrEP) among this group is stagnant. Socio-structural challenges like intimate partner violence and gendered racism can constrain PrEP access among Black women, but few implementation studies have mitigated these challenges to improve PrEP initiation. The proposed research aims to implement and assess the effectiveness, implementation, and sustainability of a multilevel intervention to increase PrEP initiation among Black women with and without intimate partner violence in Baltimore.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Enrollment

300

Conditions

HIV Prevention PrEP Women Intimate Partner Violence (IPV)

Eligibility

Sex: FEMALEMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * self-identified Black cisgender woman; * self-reported HIV-negative status, and * ≥18 years. * reports unprotected vaginal or anal sex in the past 6 months with a male sexual partner, * have at least one substantial HIV risk factor in the past 6 months according to the 2021 Centers for Disease Control (CDC) PrEP Eligibility Guidelines (i.e., HIV-positive sexual partner, recent bacterial Sexually Transmitted Disease (STD), 2+ sex partners, history of inconsistent or no condom use, commercial sex work, and residing in high HIV prevalence area or network), and * never taken PrEP Exclusion Criteria: * non-English speaking and * currently living with HIV

Outcomes

Primary Outcomes

PrEP initiation

Self-report of oral or injectable PrEP (Cabotegravir). Assessed from date of the most recent prescription.

Time frame: Post baseline up to 6 months

Secondary Outcomes

PrEP adherence

Biological assess of tenofovir (TFV) levels in client's urine

Time frame: 2-months post-randomization, 4-months post-randomization, and 6-months post-randomization

Central Contacts

Tiara C. Willie, PhD, MA

CONTACT

410-614-2686 twillie2@jhu.edu

Project Director, DrPH