- Emory University
- Jessica Sales, PhD, Emory UniversityPrincipal Investigator
- Anandi Sheth, MD, Emory UniversityPrincipal Investigator
- Ashley Phillips, MPH, Emory UniversityProject Manager
Planning4PrEP is a two-phase study of implementation of HIV pre-exposure prophylaxis (PrEP) in Title X-funded family planning (FP) clinics in the United States.
Background: Women comprise 20% of the >40,000 new infections in the US every year, with disproportionate impact on adolescent and young adult women (AYAW) in the South. Scalable HIV prevention approaches that utilize female-controlled prevention tools are required, since many AYAW are unable to successfully negotiate mutual monogamy or condom use and are unaware of their partner’s HIV risk. Pre-exposure prophylaxis is an effective, scalable, female-controlled HIV prevention strategy that is underutilized and understudied among women in the US, especially in the Southern US which has high HIV burden. To improve PrEP utilization among AYAW in the South, we propose to anchor PrEP delivery to sexual health services at Title X-funded family planning (FP) clinics. This project is comprised of two phases.
Phase 1: Guided by our implementation science frameworks, we will conduct a geographically-targeted mixed methods assessment of 600 Title X clinicians and administrators across the Southern US to ascertain vital PrEP-specific attitudes, barriers, facilitators and clinic- and provider-level capacity for promoting PrEP integration (Aim 1).
Phase 2: We will use a hybrid Type 1 effectiveness study design and partner with 3 high-volume Title X clinics located in identified HIV “hot spots” in Atlanta to develop, test and evaluate PrEP implementation plans unique to their different clinic types (Aim 2). We will then explore individual-, provider- and clinic-level factors associated with PrEP uptake, adherence and continuation among AYAW across these sites (Aim 3).
The combined results of this comprehensive implementation study will guide PrEP integration in Title X-funded clinics across the South and has the potential to directly inform future interventions to optimize PrEP uptake, adherence, and continuation among AYAW.