Optimizing PrEP Uptake and Adherence Among MSWs Using a 2-Stage Randomization Design

Multiple Principal Investigators
Matthew Mimiaga, ScD, MPH
Katie Biello, PhD
Philip Chan, MD (The Miriam Hospital)

Sponsor: National Institutes of Health (NIH)/National Institute of Mental Health

Grant Number: 
1R34MH110369-01

Male sex workers (MSW), or men who exchange sex for money, drugs, or other items of value with other men, are at exceptionally high risk for HIV infection, many of which are ideal candidates for pre-exposure prophylaxis (PrEP) – an effective biomedical intervention for reducing HIV transmission – but these men face individual, interpersonal and contextual challenges to PrEP uptake which can also pose significant barriers to optimal adherence. Informed by over a decade of formative research and programmatic work with MSWs in the United States (and globally), our interdisciplinary investigator team designed the "PrEPare for Work" package that includes two components: 1) peer-led strengths-based case management for PrEP initiation and 2) once PrEP is initiated, a counseling and problem-solving PrEP adherence intervention that addresses individualized barriers to optimal use. The present NIH grant submission is to pilot test the PrEPare for Work intervention package in a two-stage randomized controlled pilot trial in Providence, Rhode Island, providing preliminary data on acceptability and feasibility, and initial effect size estimates—all laying the groundwork for a future R01 efficacy trial.