Inter-CFAR HIV Research in Women Working Group Virtual Symposium: “Promoting Balanced Choices in HIV Prevention and Care for Women”

Dr. Kathleen Powis is an Associate Professor in Pediatrics at Harvard Medical School, a practicing Internist and Pediatrician at Massachusetts General Hospital, and a Research Associate in the Department of Immunology and Infectious Disease at Harvard T.H. Chan School of Public Health. Her research is focused on understanding health outcomes of women living with HIV and their children. She has used research findings to inform health policy. Dr. Powis serves as a member of the United States Health and Human Services Panel on Antiretroviral Therapy and Medical Management of Children Living with HIV. She has collaborated with the Panel on Treatment of HIV in Pregnancy and Prevention of Perinatal Transmission to update the guidelines around maternal HIV testing and identification of perinatal HIV exposure, a guidelines section addressing HIV testing recommendations for postpartum persons who are breastfeeding and are either living with or at risk for acquiring HIV. Dr. Powis is the co-Chair of the Inter-CFAR Collaboration on HIV Research and Women’s Health Working Group, a group that unites researchers, clinicians, community members and funders with a goal of promoting cutting-edge science in HIV research and women, developing new strategies for future research to address HIV-related issues unique to women, and promoting career development and professional growth among junior investigators interested in this field.

Dr. Alcaide is a physician scientist and leader in infectious diseases, professor of Medicine, OB/GYN, and Public Health Sciences, and Vice Provost for Research at the University of Miami. Dr. Alcaide has over 15 years of impactful HIV research focused on treatment, prevention, and the unique challenges faced by women. Her work focuses on the female reproductive tract’s microbiome and its influence on HIV vulnerability. She leads major national HIV cohort studies, the Study of Treatment And Reproductive outcomes (STAR) and the MACS/WIHS Combined Cohort Study (MWCCS), providing vital platforms for translational research on HIV and related comorbidities and reproductive health. Beyond her scientific achievements, Dr. Alcaide is a dedicated mentor, guiding junior investigators and leading national and international programs, and is deeply committed to advancing women’s health, HIV research, and global scientific excellence in the field of HIV and women.

William R Short, MD, MPH, AAHIVS, is Associate Professor of Medicine in the Division of Infectious Diseases at the University of Pennsylvania Perelman School of Medicine in Philadelphia. He received his medical degree from Hahnemann University Hospital/Drexel University College of Medicine in Philadelphia, and master’s degree in public health with a concentration in epidemiology and health systems policy from UMDNJ School of Public Health – Rutgers in Newark. Dr Short completed his residency in internal medicine and fellowship in infectious diseases from MCP/Hahnemann University Hospital. His clinical interests include the treatment and management of patients with HIV and AIDS. Dr Short has authored or coauthored articles that have been published in peer-reviewed journals such as HIV Medicine, Antiviral Therapy, Clinical Infectious Diseases, and Journal of the International Association of Physicians in AIDS Care. He is a member of the American College of Physicians, HIV Medical Association, American Academy of HIV Medicine, and Infectious Disease Society of America.  He serves as a scientific member of the Department of Health and Human Services (DHHS) guideline panel on the treatment of HIV-infected pregnant women and prevention of perinatal transmission.

Dr. Sheth is a Professor at Emory School of Medicine (Department of Medicine, Division of Infectious Diseases). Her clinical and research interests focus on the treatment and prevention of HIV among women. Dr. Sheth is PI of the Study of Treatment and Reproduction (STAR) and the Atlanta MACS/WIHS Combined Cohort Study (MWCCS). Her research program seeks to optimize delivery of HIV prevention interventions in women’s health settings and understand HIV management for women of reproductive age. She was an Associate Director of the Emory CFAR Clinical Core, Project Director of the Emory-Nigeria Research Training Program, Project Director of the Building Interdisciplinary Research in Women’s Health (BIRCWH) K12 program, and Co-Director for the Georgia CTSA postdoctoral TL1 program.

Dr. Cynthia Pauline Aluoch Auma, MBChB, is an MPH student in the Women and HIV/IARTP Program at the University of Washington (UW), funded by the Fogarty International Center. She started her professional career as the resident medical officer at a large private hospital and moved on to work as a senior medical officer in the public service where she served diverse populations in both rural and urban public facilities. Dr. Auma currently works as a clinical research scientist at the Kenya Medical Research Institute (KEMRI), Centre for Microbiology Research in Kisumu. In this capacity, she has served as a study coordinator/co-investigator on multiple implementation science studies and clinical trials including: the MOVe AHEAD study – evaluating efficacy and safety of Molnupiravir as COVID-19 prophylaxis; the INSIGHT study – evaluating young African women’s PrEP preferences as well as in Pharmacy PrEP studies – evaluating PrEP delivery in pharmacies. Her research interests focus on biomedical and behavioral interventions for HIV prevention among young African women. Her mentors include Prof. Elizabeth Bukusi (KEMRI, UW), Dr. Kenneth Mugwanya (UW) and Dr. Victor Omollo (KEMRI). 

Background: Daily oral PrEP adherence and persistence among Young African women remains low despite high HIV incidence. A decision support tool (DST) could inform perceived need for PrEP. We assessed PrEP preferences, and the acceptability and utility “MyPrEP” DST in increasing young African women’s interest in PrEP formulations. Methods: From August-December 2022, sexually active, HIV-negative women ages 16-30 from South Africa, eSwatini,
Kenya, Malawi, Uganda, and Zambia, enrolled into the INSIGHT cohort were offered daily oral PrEP at enrollment and months 1, 3 and 6. Women’s preferences for current and future PrEP options (daily, weekly and monthly oral PrEP, 2-monthly injectable cabotegravir (CAB-LA), and dapivirine vaginal ring (DVR)) was assessed at month 6, prior to administering MyPrEP DST which had modules on daily oral PrEP, CAB-LA and DVR. Participants were then asked about interest in MyPrEP formulations and its acceptability. We assessed factors influencing interest in using daily oral PrEP, CAB-LA, and DVR using multivariable logistic regression models.

Results: 3087 women with median age 24 years (IQR 21,27) enrolled. Of 2795 (90.5%) attending month 6 and using MyPrEP DST, 74.9% were South African, 95.6% had a primary sex partner, and 99.2% initiated oral PrEP over 6 months. PrEP preferences prior to using MyPrEP were CAB-LA (52.8%), monthly oral PrEP (31.5%), daily oral PrEP (25.5%), weekly oral PrEP (12.3%), and DVR (5.4%). After using MyPrEP DST, there were statistically significant increases in participants’ interest in using all PrEP formulations–CAB-LA (56.4%), daily oral (53.8%) and DVR PrEP (40.3%). Overall, 90% strongly liked getting information from MyPrEP.

Conclusion: Young African women have greater interest in using PrEP overall after engaging with MyPrEP, which provided comparative information on PrEP options to support preference-congruent decision-making. With increasing PrEP options, MyPrEP could be leveraged to support informed PrEP decisions, particularly in busy healthcare settings.

Alyssa Robillard is an associate professor. She studies health equity using a social-ecological framework to understand and address inequalities, with a focus on HIV among groups where the burden of disease is comparatively higher and the web of social and structural determinants more complex. She examines community-engaged approaches using storytelling to promote health.

Background: HIV incidence among Black women in the U.S. remains disproportionately high; the greatest burden is in the Southern U.S. HIV testing is fundamental to end the HIV epidemic and can ideally serve as a gateway to pre-exposure prophylaxis (PrEP). Storytelling interventions informed by the culture-centric model of health promotion may promote HIV prevention. This study reports preliminary feasibility of a storytelling social media-based
intervention to promote HIV testing and PrEP among Black women in the South.

Methods: The “Take Care of YOU” intervention centered a serial “community-built” story with additional health communication content delivered over 14 days through a private Facebook group. Participants (N=26) were recruited in two cohorts using targeted Facebook ads and multiple touchpoints to assess eligibility (18-39 years, Black women, with self-reported risk indications for PrEP) and eliminate bots. Participants completed a baseline (T1) and follow-up survey (T2). A cross-interview content analysis of transcribed data from qualitative post-intervention interviews (N=20) administered 1 month after T2, was used to explore intervention feasibility.

Results: Recruitment, enrollment, and retention (80.7% at T2) were effective. Participants described high acceptability for the story, intervention content, and mode of delivery, citing them as “engaging,” and “informative.” At T2, participants reported being “likely” or “very likely” to (1) get tested for HIV (61.9%) and/or (2) start taking PrEP (38.1%) in the next 3 months. Significantly higher median values at T2 were found for intention to “talk to a healthcare provider about PrEP” (V = 0.00, z = -3.49, p< .05.) and “get a prescription for PrEP” (V = 0.00, z = -3.13, p< .05) in the next 3 months.

Conclusion: This pilot study suggests proof of concept for the “Take Care of YOU” intervention to promote testing and PrEP for Black women in the South. A robust trial would further inform efficacy of this approach.

Ashley Cobb (she/her) is a certified and award-winning sexual health expert, writer, and author of Pleasure Please! The Black Woman’s Guide to Better Sex, set to be released in 2026. With a forward-thinking and inclusive approach, Ashley is dedicated to transforming how we approach sexuality and pleasure, particularly for women of color and marginalized communities. Her expertise spans a wide range of topics within sexual wellness, from reproductive health to HIV prevention to the power of pleasure. Drawing from both personal experience and professional training, Ashley creates accessible, thoughtful content that empowers individuals to explore their sexuality with confidence and authenticity. As an advocate for sexual liberation, Ashley works tirelessly to challenge harmful stigmas and promote a positive, holistic understanding of sexuality. Her approach encourages people to embrace their bodies and desires without shame, and she fosters open, supportive conversations about sexual health in both media and community spaces.

​Ashley’s work has been featured in top media outlets such as Essence, The New York Times, Huffington Post, Cosmopolitan, and Women’s Health. She bridges the gap between education and empowerment, offering practical tips, thought-provoking commentary, and a deep understanding of the intersection of health, identity, and pleasure.

​Through her writing and public speaking, Ashley advocates for equitable access to sexual health resources, with a focus on supporting those disproportionately affected by health disparities. She continues to inspire others to embrace their sexuality, challenge social norms, and build healthier, more fulfilling relationships with themselves and their bodies.

Dr. Cohn is an expert in HIV medicine, infectious disease, HIV clinical trials and health services outcomes research. She has been an active participant in the NIH/NIAID ACTG (Advancing Clinical Therapeutics Globally for HIV/AIDS and Other Infections, formerly AIDS Clinical Trials Group) since 1988, and has held numerous leadership positions within the clinical trials group including Vice Chair/Chair of the Women’s Health Committee and Outcomes Committee, Vice-Chair of the Underrepresented Populations Committee and Chair of the Women’s Health Inter-network Scientific Committee (WHISC). She has been Chair and Vice-Chair of major protocols pertaining to optimizing antiretroviral treatment, adherence, self-management and outcomes, women’s health, contraception in HIV, and recruitment of women and underrepresented populations into HIV clinical trials. Dr. Cohn has been an active member of the DHHS Perinatal Guidelines for over 20 years. Her current research areas have included enhancing adherence to antiretrovirals, improving contraception options for women with HIV, management of depression and cognitive impairment in HIV, reducing HIV stigma to improve health outcomes for African-American women, and improving access to health care and clinical trials for women and hard-to-reach populations. Throughout her career, she has been committed to advancing the careers of others and training the next generations of HIV researchers and care providers. She has maintained an active HIV/ID clinical practice currently at the Palo Alto VA and has been a teacher of HIV medicine to medical students, residents, fellows, nurses and other care professors for over 30 years.

Dr. Aadia Rana is a Professor of Medicine at the University of Alabama-Birmingham Heersink School of Medicine in Birmingham, AL USA and Director of the UAB Center for AIDS Research Implementation and Community Sciences Core. Dr. Rana’s primary research area focuses on disparities in access and adherence to medical treatment among people living with HIV, evaluation and implementation of novel antiretrovirals including long-acting antiretroviral therapy , and implementation of evidence-based interventions to improve engagement with care across the status-neutral HIV Care continuum.

Dr. Bengtson is a perinatal epidemiologist focused on improving perinatal, women’s health, and pediatric health outcomes in two main areas. First, her work explores the impact of HIV and its treatment with antiretroviral therapy during pregnancy, postpartum, and childhood. She has a particular interest in understanding how HIV and its treatment influence cardiometabolic risk for women during pregnancy and postpartum, and on mental health comorbidities, including perinatal depression. Second, Dr. Bengtson’s work addresses cardiometabolic complications, such as gestational diabetes and hypertensive disorders, during pregnancy and postpartum. Dr. Bengtson’s research portfolio includes both global (Malawi, South Africa) and domestic (American Samoa and Atlanta) projects. 

Women living with HIV (WLH) are at greater risk of cardiometabolic comorbidities than women living without HIV (WWoH) and may experience these conditions at younger ages. However, little is known about the burden of cardiometabolic comorbidities in WLH of reproductive age. Using data from the Study of Treatment and Reproductive Outcomes in Women (STAR) cohort, including WLW and WWoH across 6 sites in the Southeast United States, we assessed the prevalence of cardiometabolic comorbidities at enrollment, evaluated associations between HIV status using multivariable log binomial models, and explored effect modification by age. Cardiometabolic comorbidities were evaluated at cohort enrollment and included: 1) hypertension (systolic blood pressure (BP) ≥140 or diastolic BP ≥90 (international standard) or anti-hypertensive medication); 2) type 2 diabetes (anti-diabetic medication or HgbA1c ≥6.5% and fasting blood glucose (FBG) ≥126 mg/dL); 3) pre-diabetes (HgbA1c 5.7-6.4% and FBG 100-125 mg/dL). Among 680 women (417 WLH, 263 WWoH) at enrollment, the median age was 37 (IQR 30,41), median BMI was 32 kg/m2 (IQR 26, 42), and 75% identified as non-Hispanic Black race. Compared to WWoH in unadjusted analyses, WLH had a higher prevalence of hypertension (37% vs 29%), diabetes (14% vs 8%) and pre-diabetes (7% vs 1%) (Figure 1A) and had a higher prevalence of these comorbidities at younger ages (Figure 1B). After adjustment for age, obesity status, education, and ever smoking, HIV was not associated with prevalent hypertension (PR 0.85 95% CI 0.64, 1.13) or diabetes (PR 1.33 95% CI 0.70, 2.54) but was associated with prevalent pre-diabetes (PR 4.11 95% CI 1.20, 14.03), although precision was limited. In this diverse cohort of reproductive-aged WLH and WWoH, the burden of cardiometabolic comorbidities was high. Longitudinal follow-up is needed to determine how HIV status affects the incidence and age at onset of cardiometabolic comorbidities in reproductive-aged women.

Lauren F. Collins, MD, MSc is an Assistant Professor of Medicine in the Division of Infectious Diseases at Emory University. She is a graduate of the Boston University School of Medicine and completed her Internal Medicine residency at Duke University. She completed her Infectious Diseases fellowship and Master of Science in Clinical Research at Emory University. Dr. Collins’ clinical and research interests focus on improving the care of persons with HIV and in particular, women with HIV and those affected by the Southern HIV/AIDS epidemic. In her research, she studies the mounting burden of non-AIDS comorbidities experienced by aging persons with HIV and specifically investigates the role of premature aging, sex differences, shared mechanistic drivers, and traditional and HIV-specific risk factors contributing to overall comorbidity burden. She is also interested in the clinical, service delivery and public health implications of coinfections affecting persons with HIV, namely chronic HCV and SARS-CoV-2. She is a recent KL2 career development awardee supported by the Georgia Clinical and Translational Science Alliance and her project evaluates the use of a novel retinovascular imaging tool to explore microvascular dysfunction as a common pathogenesis – and potential screening target – of age-related comorbidities among women with and without HIV. Dr. Collins is also a co-investigator for the Women’s Interagency HIV Study (WIHS) and the Emory Specialized Center of Research Excellence on Sex Differences (SCORE).

Background: Long-acting injectable (LAI) antiretroviral therapy (ART), administered every 4 or 8 weeks, provides a long-awaited alternative to daily pills for HIV treatment. Given the unique biologic, psychosocial, and structural factors that affect reproductive age women’s ability to access and adhere to ART, it is critical to assess their willingness and preferences for treatment modalities.

Methods: We analyzed data collected among participants enrolled in the Study of Treatment And Reproductive Outcomes (STAR), an observational cohort of women aged 18-45 years enrolled across six Southern sites via academic-community partnerships: Atlanta, GA; Birmingham, AL; Chapel Hill, NC; Jackson, MS; Miami, FL; and Washington, D.C. Sociodemographic variables were collected via the parent study, through which women with HIV (WWH) completed a onetime survey on LAI ART knowledge and attitudes between 12/2022 and 12/2024. Outcomes on LAI ART were assessed based on responses to “How likely are you to try LAI HIV treatment instead of daily pills?” (primary) and “Given the choice between long-acting shots every two months in the butt or daily pills for HIV treatment, which would you prefer?” (secondary). Associations between outcomes with participant characteristics were determined.

Results: Among 426 WWH surveyed, median (Q1-Q3) age was 38 (32-42) years, 78% identified as nonHispanic Black, 67% had a body mass index ≥30 kg/m2 , 50% had ≥3 prior pregnancies, 35% reported a history of sexual violence and 23% housing insecurity. At the time of the survey, median time since HIV diagnosis was 12.2 (5.7-19.0) years, median CD4+ T-cell count was 717 (491-988) cells/mm3 , 84% reported near-perfect (≥95%) oral ART adherence and 87% had HIV1 RNA <200 cp/mL. The majority of WWH (n=246; 58%) had heard of LAI ART and 20 (5%) were currently using this treatment modality. Of the 406 WWH not using LAI ART, 245 (60%) reported they would probably/definitely try LAI ART, 101 (25%) reported they would probably/definitely not try LAI ART, and 60 (15%) were not sure. Willingness to try LAI ART was significantly associated with age (p<0.009), history of sexual violence (p=0.006), and reported ART adherence (p=0.03); and there was a trend toward association with housing status (p=0.07), but not with race/ethnicity, enrollment site, or viral suppression. In terms of preference for HIV treatment modality (N=426 WWH), 249 (58%) preferred LAI ART, 115 (27%) daily pills, 42 (10%) were not sure, 16 (4%) had no preference, and four women responded they would not take HIV treatment regardless of formulation. Of 20 WWH using LAI ART, 18 preferred this modality to daily oral ART. Preference for LAI versus oral ART was associated with age (p<0.0004), reported adherence (p=0.01); and there was a trend toward association with viral
suppression (p=0.08), but not with other sociodemographic characteristics assessed.

Conclusion: In a diverse cohort of reproductive-aged WWH with high rates of well-controlled HIV and living in the South, there was a high willingness to try, and preference for, LAI versus oral ART. HIV treatment modality interest and preference differs by sociodemographic characteristics, highlighting that no ‘one-size-fits all.’ These data underscore the need to develop decision tools and approaches that support women’s choice in an era of an evolving HIV treatment landscape.

Arnetta Phillips was a Clinical Research Coordinator at the University of Miami Miller School of Medicine. She has worked at the University of Miami for over 29 years fulfilling job functions such as project coordination, recruitment and data collection in research studies geared toward prevention and intervention of HIV and substance use. Ms. Phillips’ experience is far-reaching as she has worked with diverse populations and age groups. She has worked with runaways, people living with HIV and those with substance use disorders. Ms. Phillips has also done much research with populations of children, adolescents, women and men. Ms. Phillips has been a certified addiction counsellor for over a decade. This training and expertise have led her to work with a wide variety of populations, such as women with breast cancer and bipolar disorder. She has also made significant contributions through her work in a maternal addiction program and relapse prevention programs. Much of Ms. Phillips’ contribution has been geared towards individuals with HIV, substance use and addiction. Ms. Phillips is a Vietnam veteran who served in the US Air Force for fourteen years- eight years active duty and six years active reserve. Arnetta Phillips is especially passionate about working with women living with HIV. She believes her life’s purpose is to give back, encourage others and instill hope by sharing her story with others living with HIV. She aspires to continue to reach out to, educate and inspire women who are living with HIV.

Gaea Daniel, PhD, RN, PMHNP-BC, is Assistant Professor at Nell Hodgson Woodruff School of Nursing, Emory University, where her program of research focuses on understanding the sociocultural and environmental influences that affect sexual health behaviors and outcomes. She is particularly interested in sexual health outcomes of Black women that present as race-based disparities, including STIs and HIV/AIDS. Dr. Daniel devotes her time to health equity-related initiatives in her research and the nursing profession, and she is co-editor of the award-winning book Taking Action: Top 10 Priorities to Promote Health Equity and Well-being in Nursing. Dr. Daniel lives in Metro Atlanta, Georgia, and is passionate about working with and in the community to serve others.

Jennifer McKinney, MD MPH is an Assistant Professor of Maternal Fetal Medicine at Baylor College of Medicine in Houston, Texas. Her main clinical and research interests include infectious disease (especially HIV) in pregnancy, as well as public health program design and implementation. She currently leads the maternal HIV program within the county hospital system in Harris County, one of the largest maternal HIV programs in the United States. She is also Maternal Medical Director at Ben Taub Hospital in Harris County where she leads the obstetric quality and performance improvement (QAPI) program. Through her clinical, research, and quality improvement work, she strives to improve care for all pregnant patients living with HIV at the local, state, and national levels.

Deja Knight, MPH, MA, is a PhD candidate in the Social and Behavioral Interventions program in the Department of International Health at the Johns Hopkins Bloomberg School of Public Health. Her research focuses on intersectional social determinants of health, HIV, and substance use in the United States, specifically among minoritized and low-resource communities. Deja is a graduate research assistant in both the Department of International Health and Department of Mental Health. She also serves as a Steering Committee Member in the Department’s IDARE Group and is a Teaching Council Fellow at the School. She also serves as a Section Counselor in the Community Health Planning and Policy Development Section of the American Public Health Association. Previously Deja’s professional work included providing risk assessments and free, confidential HIV and Hepatitis C testing to high-risk communities in Iowa. Deja is passionate about promoting health equity and committed to addressing health disparities in communities through her research and advocacy.

Background: Despite the proven efficacy of pre-exposure prophylaxis (PrEP) for HIV prevention, uptake remains disproportionately low among Black Americans and young adults. Historically Black Colleges and Universities (HBCUs) represent trusted, culturally resonant institutions with untapped potential for promoting PrEP equity. However, implementation determinants within these settings remain understudied. This scoping review synthesizes current evidence on PrEP implementation efforts, readiness, and outcomes across HBCU contexts to inform tailored strategies for PrEP delivery.

Methods: We conducted a comprehensive literature search across PubMed, CINAHL Plus, Embase, Scopus, Web of Science, and ERIC for peer-reviewed articles published between 2015 and 2025. Studies were included if they examined any aspect of PrEP on HBCU campuses, including barriers, facilitators, or implementation outcomes. Two reviewers independently screened articles using Covidence software. Six articles met inclusion criteria.

Findings: Two studies focused on formative research examining PrEP awareness, acceptability, and uptake barriers (e.g., stigma, side effects, and financial concerns). These studies found PrEP to be acceptable among students yet hindered by structural and sociocultural barriers. Two additional studies assessed organizational readiness, highlighting variability in institutional resources, external partnerships, and alignment with student needs and university culture. The remaining studies evaluated early post-implementation outcomes, demonstrating positive impacts on PrEP knowledge and behavioral intentions when interventions were student-centered and culturally tailored.

Conclusions: HBCUs present unique opportunities for PrEP implementation but face structural and contextual challenges, including limited resources and institutional readiness. PrEP delivery requires implementation strategies tailored to each HBCU’s capacity, campus culture, and student priorities. Strengthening partnerships, investing in prevention infrastructure, and centering students’ voices are critical to transforming HBCU campuses into proactive hubs for HIV prevention.

Salome completed her PhD in epidemiology from McGill University where her research focused on the implications of intimate partner violence for HIV control in women, girls, and infants. Prior to her PhD, Salome worked on implementation research studies in India, Tanzania, South Africa and Malawi. 

Background: The 2025 US National HIV/AIDS Strategy identifies intimate partner violence (IPV) as a key  non-medical determinant of health in the HIV response. Women living with HIV (WLHIV) face heightened IPV risk, especially during pregnancy. We evaluated the associations between reproductive stage, structural risk factors and past-year IPV among WLHIV in the US.

Methods: We conducted a cross-sectional analysis using 2022-2025 baseline survey data from the Health Outcomes around Pregnancy and Exposure to HIV/Antiretrovirals (HOPE) prospective cohort of WLHIV across 14 sites in 9 US states/territories. The outcome was past-year experience of physical, sexual, or psychological IPV or reproductive coercion. Reproductive stage was categorized as nulliparous, postpartum, parous/non-pregnant, and pregnant. We used generalized estimating equations to estimate prevalence ratios for the association of each risk factor with IPV. We fit separate models for each risk factor, adjusting for age, race, education, income, marital status, and study region. In evaluating reproductive stage, we also adjusted for the number of sex partners in the past year. We assessed the impact of non-response to IPV questions.

Results: Among 742 participants, 538 (79%) had complete data on past-year IPV. Over one in four WLHIV (26.4%) had experienced past-year IPV. Pregnant women had 4 times the prevalence of reproductive coercion (aPR=4.0; 5%CI:1.7-9.5) and 1.7 times (aPR=1.7; 95%CI: 1.3-2.3) the prevalence of psychological IPV, compared to parous/non-pregnant women. Early sexual debut (aPR=2.3; 95%CI:1.2-4.5), transactional sex (aPR=2.1; 95%CI:1.3-3.4), drug use (aPR=1.7; 95%CI:1.1-2.6), and adverse childhood experiences (aPR=1.2; 95%CI:1.1-1.2) were associated with past-year IPV. At a structural level, housing instability (aPR=2.1; 95%CI 1.3-3.5), food insecurity (aPR=2.3, 95%CI: 1.8- 3.1), and frequent neighborhood violence (aPR=1.8; 95%CI: 1.1-3.0) were associated with elevated IPV prevalence.

Conclusions: IPV is prevalent among WLHIV, especially during pregnancy. Policies should prioritize comprehensive contraceptive
access and IPV screening to address the HIV-IPV syndemic.

Salome KUCHUKHIDZE, PhD1§, Deborah KACANEK, ScD2, Sean S. BRUMMEL, PhD2, Mariam DAVTYAN, PhD3, Jessica LEE, MSc2, Kunjal PATEL, DSc4, Minttu M. RÖNN, PhD5, Jecca R STEINBERG, MD, MSc6, Paige L. WILLIAMS, PhD2,4,7, Lynn M. YEE, MD, MPH8, Jeffrey W. IMAI-EATON, PhD1,9, Kathleen POWIS, MD10 for the HOPE study team.

Eileen Scully is an Associate Professor of Medicine at the Johns Hopkins University. She earned her MD and a PhD in Immunobiology from the Yale University School of Medicine and completed Internal Medicine residency at the Brigham & Women’s Hospital in Boston followed by Infectious Diseases fellowship at the Harvard Combined program. Dr. Scully did additional dedicated training as the HIV fellow focused on clinical care of people living with HIV. After a postdoctoral fellowship at the Ragon Institute of MGH, MIT and Harvard, Dr. Scully started her laboratory studying HIV immunopathogenesis and cure, and moved the lab to Johns Hopkins in 2016. She is active in translational research, co-chairing an interventional cure trial through the ACTG specifically in women and serving on the lnter-CFAR HIV in Women Executive Committee. At Johns Hopkins she teaches a longitudinal curriculum on HIV to the ID fellows, leads the weekly CFAR clinical conference and is the Director of the CFAR clinical core, co-Directs the Physician Scientist Pathway in the Osler Medical Residency program and cares for patients in both the Bartlett clinic and on the dedicated inpatient HIV service.

Ms. Pooja Maheria, MS is a Data Analyst in the Department of Infectious Diseases at the University of Alabama at Birmingham (UAB). She completed her Master’s in Data Science from the UAB. She works as the lead data analyst for the Patel Research Group, in collaboration with Dr. Rena Patel, at UAB. Ms. Maheria leverages her knowledge of advanced analytic and statistical methods to work in HIV and reproductive health, with a particular focus on pregnancy outcomes. This work supports mixed-methods (quantitative and qualitative) studies that further elucidate interactions of health factors and the delivery of care among women living with HIV and pregnant people. She is dedicated to the use of data to catalyze equitable, evidence-based interventions and is involved in several collaborative efforts to improve health systems and health outcomes for diverse populations from historically marginalized contexts.

Background: While differences in access to COVID-19 therapeutics have been documented, the intersection of HIV status and treatment access remains largely unexplored. Leveraging the National Clinical Cohort Collaborative (N3C), a nationally sampled electronic health records repository, we investigated differences in COVID-19 therapeutic prescriptions among persons with HIV (PWH) and without HIV (PWoH).

Methods: We retrospectively analyzed COVID-19 therapeutic prescriptions (remdesivir and nirmatrelvir/ritonavir) among PWH and PWoH using N3C data from January 2020 to November 2024. Hierarchically nested logistic regression models adjusted for covariates assessed associations between therapeutic receipt and patient characteristics, while multivariate linear regression with time as a covariate examined trends and differences by HIV status.

Results: Our analysis included 7,806,412 patients diagnosed with COVID-19, of whom 45,508 (0.58%) were PWH. Overall, 507,901 (6.5%) received nirmatrelvir/ritonavir or remdesivir, with higher use of nirmatrelvir/ritonavir, especially in the 65+ age group (10.4%, n=222,931). PWH had significantly higher adjusted odds of receiving therapeutics than PWoH: remdesivir aOR 1.26 (95% CI: 1.20, 1.33); nirmatrelvir/ritonavir aOR 2.86 (95% CI: 2.77, 2.95). Nirmatrelvir/ritonavir use increased in all US regions, peaking in the South at 42% and lowest in the West at 37% by late 2024. Remdesivir utilization peaked highest in the Midwest at 12%, moderately in the Northeast at 10%, and remained lower in the South and West at 8% over the study period.

Conclusion: PWH had higher odds of receiving COVID-19 therapeutics than PWoH, possibly reflecting greater comorbidities or better care access.  However, racial/ethnic inequities persist, with lower estimated receipt of remdesivir and nirmatrelvir/ritonavir among minority groups. Differences by region persist, and future research should investigate how to reduce barriers and assure equitable access to therapies everywhere.

Abigail LeCates, B.A is a fourth-year medical student at Emory School of Medicine in Atlanta, GA. She completed her B.A. in Anthropology at Amherst College in Amherst, MA. She is interested in community-based healthcare interventions to promote health equity, and her research interests include LGBTQ+ health and HIV prevention. She is planning to pursue medical residency in Internal Medicine.

Background: While women account for a growing number of new HIV diagnoses, the interplay between behavioral and socio-structural factors complicates HIV risk assessment. This study quantified these factors’ impact on HIV risk among women receiving care at Grady Health System (GHS) in Atlanta.

Methods: This retrospective cohort study included women aged ≥18 years, with ≥1 encounter at GHS between 2012-2022. The primary outcome was a new HIV diagnosis during the study period. Multivariate logistic regression identified socio-structural and behavioral factors associated with HIV. Socio-structural models adjusted for age, race, and ethnicity; behavioral factors also adjusted for Social Vulnerability Index (SVI). STI models further accounted for substance use, other STIs, and STI testing frequency.

Results: Of 333,263 individuals, 617 (0.20%) had a new HIV diagnosis (mean age 41 years, 89% Black). Socio-structural factors were common: 83% lived in high HIV incidence ZIP codes, 47% had moderate-to-high SVI, and 19% had residential mobility (>3 addresses in a year). Behavioral factors included substance use (28%) and at least one laboratory-confirmed bacterial STI in the two years prior to diagnosis (9.4%), including 3.9% with gonorrhea and 1.3% with syphilis. In multivariate analysis, socio-structural factors were strongly associated with HIV risk, including residing in a high HIV incidence ZIP code (OR 4.5, 95% CI 3.7-5.6), moderate-to-high SVI (OR 1.7, 95% CI 1.5-2.0), and residential mobility (OR 2.2, 95% CI 1.8-2.7). Associated behavioral factors included substance use (OR 3.8, 95% CI 3.1-4.6) and positive syphilis (OR 8.7, 95% CI 2.9-5.1), and gonorrhea (OR 3.2, 95% CI 1.9-5.1) tests within 2 years before diagnosis.

Conclusion: In this cohort of predominantly Black women, socio-structural factors were more prevalent and strongly associated with HIV risk than were bacterial STIs, thus underscoring the importance of socio-structural factors in HIV risk assessment in these patients.

Maria Alcaide is an Infectious Diseases physician scientist, faculty member of the University of Miami for over 15 years. Throughout her career as a clinician and researcher, Dr. Alcaide has provided scientific and administrative oversight to numerous multidisciplinary research studies focused on HIV and other emerging infections in the US and other international settings. Dr. Alcaide has served as a principal investigator on many NIH-funded studies. Her research portfolio in 2022 was over $10 million, and she is among the top funded NIH scholars. She has provided exceptional leadership as Director of Clinical Research since 2020 at the Miller School of Medicine. She is also the director of the Miami CTSI and the Miami Center for AIDS Research mentoring programs, and plays a critical role in mentoring junior investigators, with a focus on women and underrepresented groups. As the Vice Provost for Research and Scholarship, she will oversee the University’s burgeoning research portfolio under the Office of the Vice Provost for Research Administration, and the development of university-wide scholarship initiatives.

Omar Gustavo Sued, MSc, MD, PhD is an Internal Medicine and Infectious Diseases Specialist from Argentina, currently serving as Regional Advisor for HIV Treatment and Care at the Pan American Health Organization (PAHO/WHO), the World Health Organization’s office for the Americas, based in Washington, D.C. He earned his medical degree from the Universidad Nacional de Córdoba and specialized in Infectious Diseases at the Universidad de Buenos Aires. He later completed a Master’s and PhD in Acute HIV Infection at the University of Barcelona, Spain. Dr. Sued has worked in HIV care since 1997, across diverse settings. Between 2012 and 2021, he was Director of Research at Fundación Huésped, a leading Argentine NGO focused on HIV and infectious diseases. Under his leadership, the department joined major international research networks such as the HIV Prevention Trials Network, AIDS Malignancies Consortium, and HIV Vaccine Trials Network. Dr. Sued was President of the Argentinean Infectious Disease Society (SADI) from 2019 to 2021, and previously served as its Treasurer (2015–2019) and Secretary (2013–2015). He chaired the National Infectious Diseases Congress in 2016 and 2021. He has contributed to several WHO guideline development groups, including those on post-exposure prophylaxis, co-trimoxazole prophylaxis, cryptococcal disease, and antiretroviral therapy. He has authored or co-authored over 175 peer-reviewed publications, book chapters, and clinical guidelines.

Dr. Sued is also a Governing Council Member of the International AIDS Society (IAS), representing Latin America and the Caribbean. He has actively participated in IAS and AIDS conferences, serving as rapporteur, co-chair, and lead presenter, and is a strong advocate for evidence-based interventions and human rights for people living with HIV.

Elizabeth Barr is the Associate Director for Interdisciplinary Research at the NIH Office of Research on Women’s Health (ORWH). In this role, she leads strategic initiatives that strengthen cross-sector collaboration and address biopsychosocial drivers of women’s health outcomes. Dr. Barr is a community-trained researcher with over 15 years of experience advancing HIV research and women’s health through interdisciplinary, data-driven, and community-engaged approaches. Since joining ORWH in 2019, Dr. Barr has advanced integration of social determinants of health (SDOH) into women’s health research, managed and expanded the ORWH interprofessional education program, and developed initiatives centered on HIV and women. Dr. Barr earned her Ph.D. from the University of Wisconsin–Madison in Rhetoric, Politics, and Culture and her M.S. from Towson University in Women’s and Gender Studies. Prior to joining ORWH, she served on the faculties of Towson University and the University of Maryland, Baltimore County, where she led interdisciplinary, cross-sector projects aimed at increasing women’s engagement in health research.

Ciarra “Ci Ci” Covin is a dedicated board-certified human services practitioner with a profound commitment to advocating for the autonomy of women living with HIV and their families. Through her lived experience as a woman living with HIV and skill to connect with diverse communities through the skill of storytelling, Ci Ci has emerged as a respected and sought-after speaker, expert, and facilitator within the HIV community and beyond. In her capacity as Director of Programs at The Well Project, she tirelessly advocates for their needs and ensures they receive adequate support from healthcare teams, fostering an environment where autonomy and informed choices are prioritized. With her expertise and passion, Ci Ci is poised to make a significant impact through intentional collaboration to reach the communities who need it the most.