Journal of the International AIDS Society · 2026
PrEP4Her: Evaluating the Reach, Adoption, Preliminary Effectiveness and Fidelity of a Multi-Component Hybrid Type 3 Trial Designed to Increase PrEP Prescriptions for Black Women Receiving Gynaecologic Care in a University-Affiliated Women's Health Setting in the United States South.
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Mahone Anais, Williams Audra, Cleveland Dave, Johnson Bernadette, Watson Grace, Kempf Mirjam-Colette, Matthews Lynn T, Mugavero Michael J, Elopre Latesha E
Аннотация
INTRODUCTION: To address suboptimal HIV pre-exposure prophylaxis (PrEP) uptake among Black women, we designed PrEP4Her, a multi-phase, multi-component implementation strategy aimed to increase PrEP prescriptions among women receiving routine health services at a university-affiliated gynaecology (GYN) clinic located in the Southeastern United States.
METHODS: Informed by intervention mapping, PrEP4Her, a hybrid type 3 trial, was piloted over 8 months, January 2024-August 2024, and the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) conceptual framework guided the evaluation of proximal implementation outcomes. In this manuscript, we present (1) Reach (the number of Black women prescribed PrEP and the proportion of PrEP prescribed to women with an indication, having a sexually transmitted infection (STI) within 12 months and/or reporting >1 sex partners collected from a universal health screener); (2) Adoption (the number of PrEP prescribers); (3) Preliminary Effectiveness (PrEP prescribed over time). Also, we measured the number of Black women who self-reported talking to a doctor about PrEP as a secondary outcome (Fidelity). We collected evaluative data from the electronic health record (EHR), sexual health screener and self-administered post-visit survey. Descriptive statistics were utilized to describe the sample, and chi-square tests examined the relationships between patient characteristics and talking to providers about PrEP. Analyses were completed in October 2025.
RESULTS: EHR data indicate there were 1274 unique first clinic visits. Most women identified as Black race (58%) and, on average, were 34 (±11.3) years old. Ten PrEP prescriptions were written by seven prescribers (i.e. adoption). Among women prescribed PrEP, nine identified as Black women and none had a recent STI (i.e. reach). PrEP was prescribed once before the pilot, eight times during the pilot and once in the month after the pilot. However, PrEP was not prescribed to women with PrEP indications (N = 85) (i.e. preliminary effectiveness). Nearly half (43%) of surveyed women reported talking to a provider about PrEP (i.e. fidelity); most (49%) identified as Black race. Chi-square tests show significant differences by race (p = 0.02).
CONCLUSIONS: We observed an increase in PrEP prescriptions from before to during the pilot period; however, 85 women with PrEP indications were not prescribed PrEP. Future research will further evaluate PrEP4Her's acceptability and feasibility.
METHODS: Informed by intervention mapping, PrEP4Her, a hybrid type 3 trial, was piloted over 8 months, January 2024-August 2024, and the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) conceptual framework guided the evaluation of proximal implementation outcomes. In this manuscript, we present (1) Reach (the number of Black women prescribed PrEP and the proportion of PrEP prescribed to women with an indication, having a sexually transmitted infection (STI) within 12 months and/or reporting >1 sex partners collected from a universal health screener); (2) Adoption (the number of PrEP prescribers); (3) Preliminary Effectiveness (PrEP prescribed over time). Also, we measured the number of Black women who self-reported talking to a doctor about PrEP as a secondary outcome (Fidelity). We collected evaluative data from the electronic health record (EHR), sexual health screener and self-administered post-visit survey. Descriptive statistics were utilized to describe the sample, and chi-square tests examined the relationships between patient characteristics and talking to providers about PrEP. Analyses were completed in October 2025.
RESULTS: EHR data indicate there were 1274 unique first clinic visits. Most women identified as Black race (58%) and, on average, were 34 (±11.3) years old. Ten PrEP prescriptions were written by seven prescribers (i.e. adoption). Among women prescribed PrEP, nine identified as Black women and none had a recent STI (i.e. reach). PrEP was prescribed once before the pilot, eight times during the pilot and once in the month after the pilot. However, PrEP was not prescribed to women with PrEP indications (N = 85) (i.e. preliminary effectiveness). Nearly half (43%) of surveyed women reported talking to a provider about PrEP (i.e. fidelity); most (49%) identified as Black race. Chi-square tests show significant differences by race (p = 0.02).
CONCLUSIONS: We observed an increase in PrEP prescriptions from before to during the pilot period; however, 85 women with PrEP indications were not prescribed PrEP. Future research will further evaluate PrEP4Her's acceptability and feasibility.