EMPOWER

Title:

Encouraging Multiple PrEP Options for Women Engaged in PRimary Care (EMPOWER)

Dates:

August 13, 2024 – July 31, 2026

Funding Source:

National Institute of Mental Health (NIMH)

Grant Number:

1R34MH137721-01

Background:

Approximately 1.2 million people in the U.S. live with HIV. Cisgender women comprise nearly 20% of new cases, largely acquired through heterosexual transmission. Black and Hispanic women and those with low health literacy are disproportionately affected. Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention method, yet up to 90% of women are unaware of it, and only 10% of those indicated for PrEP receive it. Primary care providers (PCPs), who are crucial in reaching marginalized women, often lack the training, resources, and time to offer PrEP education. To address this, the EMPOWER strategy uses electronic health records (EHRs) to: deliver accessible PrEP education via the patient portal to women in primary care, enable self-scheduling for PrEP discussions for those who choose to learn more, and to provide PCPs with clinical decision support for counseling and prescribing PrEP to women.

Abstract:

We will adapt and pilot test a technology-enabled, primary care-based, health literacy strategy to empower women to make informed decisions about PrEP.

Our proposed R34 Encouraging Multiple PrEP Options for Women Engaged in PRimary Care (EMPOWER) therefore offers a pragmatic and innovative approach to the delivery of PrEP information to women in primary care. The EMPOWER strategy addresses well-documented barriers and ‘missed opportunities’ for HIV prevention among cisgender women and supports informed PrEP decision-making by: 1) delivering understandable, actionable, and non-stigmatizing PrEP education, in multiple formats and languages, directly and securely to women in primary care via the patient portal; 2) enabling women to discreetly self-schedule a visit to discuss PrEP options with either their own PCP or with a female PCP who has years of experience in PrEP delivery; and 3) supporting PCP counseling via clinical decision support comprised of standardized, patient-centered language to guide PrEP discussions and ‘smart sets’ to facilitate PrEP prescribing, when desired. Our specific aims are to: 1) Adapt and coordinate the EMPOWER strategy to support informed decision-making among diverse cisgender women seen in primary care; 2) Pilot test the efficacy of the EMPOWER strategy, compared to an attention control, on PrEP knowledge, stigma, and future intention to use PrEP; and 3) Assess the reach, adoption, implementation, and maintenance of EMPOWER components

ClinicalTrials.gov identifier:

NCT04976881

Contact

Principal Investigator: Allison Pack, PhD MPH
Project Manager: Evelyn Velazquez, MPH