Federal Project Grant Award Summary

The National Institute of Mental Health (NIMH) awarded The Johns Hopkins University a $1,995,285 Project Grant effective June 10, 2026 through June 9, 2029 under the Mental Health Research Grants program (CFDA 93.242). This award supports a national study to assess the reach and public health impact of pharmacist-prescribed HIV pre-exposure prophylaxis (PrEP). The research will evaluate where pharmacist-prescribed PrEP is occurring across states that permit it, which populations are being reached by pharmacist prescribers, and comparative HIV infection rates among patients prescribed PrEP by pharmacists versus other healthcare providers. The study addresses a critical knowledge gap, as pharmacist autonomous prescribing of PrEP has rapidly expanded in the United States—with the number of states authorizing this practice more than quintupling in five years—yet rigorous national data on implementation patterns and public health impact remain limited.

The research team will leverage population-based surveillance metrics using national pharmacy claims data to assess PrEP adherence, persistence, and subsequent HIV rates across the nation. This investigation builds on the team's prior identification of a novel adherence metric demonstrating that approximately one in five patients with insurance-approved oral PrEP prescriptions did not fill their medication, with over 70 percent failing to obtain PrEP within 365 days—a pattern associated with up to five times higher HIV infection risk compared to consistent users. By analyzing pharmacist-prescribed PrEP at the national level, this study will generate evidence to inform policy decisions and optimize HIV prevention strategies in areas of greatest need.