JMIR Publications

ABSTRACT

Background:

Although HIV pre-exposure prophylaxis (PrEP) has been proven to be an effective prevention tool in decreasing HIV transmission, achieving adequate PrEP uptake has remained a challenge among Black cis-gender women living in the South. Gynecology clinics, which provide primary health care services for many black cis-gender women, has a potential to be an ideal setting for integration of PrEP services.

Objective:

We designed an intervention, PrEP4Her, which aims to implement PrEP service delivery at gynecology clinics as part of routine reproductive and sexual health care visits to improve PrEP engagement rates among Black cis-gender women.

Methods:

Guided by the information gathered on 1) factors that may impact PrEP implementation at gynecology clinics including key barriers/facilitators to PrEP implementation and potential strategies to address the identified barriers, 2) structural barriers and provider-level barriers to PrEP implementation, and 3) implementation strategies on how to integrate PrEP services into routine gynecology care, a multi-component implementation strategy was developed to integrate PrEP in routine women’s health visits (i.e. PrEP4Her).

Results:

We will measure implementation outcomes grounded in the RE-AIM framework: reach will be assessed by the number of black cis-gender women receiving a PrEP prescription and the proportion of black cis-gender women with PrEP prescriptions among those with PrEP indication, efficacy will be evaluated by the improvement in the number of PrEP prescriptions over time, and adoption will be assessed by the extent of PrEP4Her intervention adoption by the clinic staff. Additionally, acceptability, feasibility, and fidelity of the intervention protocol will be assessed.

Conclusions:

Upon completion of our proposed research, our inter-disciplinary team, which includes experts in infectious diseases, implementation science, community-engaged research and psychology, will be primed to lead a multi-site type III implementation trial of PrEP service delivery at gynecology clinics across the South.