PROJECT SUMMARY
Background. In Nigeria, sexual minority men (SMM) have disproportionately higher levels of HIV
compared to the general population. With high adherence, daily oral pre-exposure prophylaxis (PrEP)
reduces risk for HIV acquisition among SMM. Increasing PrEP uptake and adherence could
significantly reduce HIV incidence, but to date no PrEP intervention have focused on SMM in Nigeria.
The scientific premise of this K01 application is that a telehealth delivery model for PrEP could
circumvent barriers to PrEP access for SMM in Nigeria. There is a strong proof of concept for the
proposed approach given that telehealth interventions to enhance PrEP access have been shown to
be acceptable and have increased PrEP uptake and adherence, among SMM in the U.S. While
telehealth interventions in Nigeria have increased utilization of other health services, no study has
investigated the feasibility, acceptability, and efficacy of delivering PrEP health services to SMM in
Nigeria through a telehealth approach.
Overview of project. My long-term goal is to become an independent researcher with expertise in
developing and testing telehealth interventions to improve HIV prevention and care outcomes among
SMM in sub-Saharan Africa. In Year 1, I will conduct qualitative interviews with HIV-negative SMM
(n=20), peer educators (n=20), and healthcare providers (n=20) in Lagos Nigeria to identify the
content, format, and foreseeable challenges to implementing a telemedicine intervention to increase
PrEP awareness, uptake, and adherence among SMM. In Year 2, I will conduct qualitative interviews
with SMM (n=30) to iteratively design a telemedicine intervention to increase PrEP uptake and
adherence among SMM in Lagos, Nigeria. In Years 3-5, I will conduct a pilot randomized controlled
trial (RCT) to test the feasibility, acceptability, and preliminary efficacy of the telemedicine intervention
to optimize PrEP adherence over 6 months with 90 PrEP-naïve, HIV-negative high risk SMM in
Lagos, Nigeria. My successful completion of the proposed research and training aims will position me
to submit a R01 in the final year of this grant to conduct a multisite, RCT to test the intervention’s
efficacy.
