Advancing prep access for women in georgia

The National Institute of Allergy and Infectious Diseases awarded Research Triangle Institute (RTI International) $719,107 on September 2, 2026, under the Allergy and Infectious Diseases Research program (CFDA 93.855) to evaluate a multilevel intervention addressing pre-exposure prophylaxis (PrEP) barriers for women in Georgia.

RTI will compare the combined efficacy of provider PrEP training and the SavvyHer mobile application—designed to help women make decisions about using PrEP—against training-only and app-only arms in increasing provider adoption of PrEP and patient uptake. Primary outcomes measure the weekly number of PrEP-eligible women offered PrEP by participating providers at 3-, 6-, and 9-month follow-ups, and patient-perceived appropriateness of PrEP use. The study addresses documented barriers: low PrEP uptake among women despite Georgia's HIV incidence rate of 26.0 per 100,000, women's perception that PrEP messaging targets men rather than women, and provider knowledge gaps or reluctance to prescribe PrEP.

RTI collaborates with Emory University, Morehouse School of Medicine, Sisterlove Inc., and a Community Collaborative Board in study design and implementation. Work is performed in Durham, North Carolina, with a period of performance extending from September 2, 2026, through August 31, 2031.

Abstract

The HIV incidence rate in georgia is 26.0 per 100,000, but despite this high rate, pre-exposure prophylaxis (PREP) uptake is still low, especially among women. Research indicates that most women perceive PREP as inappropriate for them because of ubiquitous PREP messaging featuring men. However, once women are educated about PREP, they are open to taking oral and injectable PREP, prefer to receive IT from their usual care providers, and value their providers' PREP recommendation. Increasing PREP awareness among women may not be sufficient for PREP uptake because of barriers to access, including lack of provider knowledge or confidence to prescribe PREP. Indeed, most providers in the south do not prescribe PREP. Therefore, IT is important to address both women's perception and knowledge related to PREP and providers' ability to provide PREP. The proposed study will evaluate a multilevel approach to address PREP barriers. Two strategies to support women and providers in PREP decision-making and to increase access and uptake have been developed and piloted with women and the providers who serve them. The PREP training is designed to help providers present PREP as an HIV prevention option to women and provide women- centered PREP care. The savvyher mobile application is designed to help women make decisions about using PREP. RTI international, emory university, morehouse school of medicine, sisterlove, INC., and our community collaborative board (CCB) have designed the proposed study and specific aims. Aim 1: compare the combined efficacy the PREP training and the savvyher APP on provider PREP adoption (i.e., the weekly number of PREP-eligible women who are offered PREP) by the 3- and 6-month follow-UPS and maintenance by the 9-month follow-up relative to the effects of the training-only and APP-only arms. Aim 2: assess the combined efficacy of these strategies on patients' perceived appropriateness of PREP and PREP reach (i.e., proportion of participants who initiate PREP) by the 3- and 6-month follow-UPS and persistence (i.e., refills/injections) by the 9-month follow-up compared with the training-only and APP-only arms. Aim 3: explore the facilitators and barriers to PREP provision, uptake, and use of the strategies among providers and patients via journey mapping interviews. If efficacious, these interventions can be scaled up to have an immense public health impact, helping to reduce HIV among women.