Building access to HIV prevention
ALBANY—Melonie Walcott, assistant professor in the Department of Health Policy, Management, and Behavior at the University at Albany, has secured $1.4 million in funding from the Centers for Disease Control and Prevention to lead a four-year study aimed at improving access to HIV prevention for Black cisgender women in New York State.
The study, titled “PrEP-WISE” (Pre-Exposure Prophylaxis for Women in Charge of Sexual Decision-Making and Engagements), focuses on addressing disparities in the uptake of PrEP, a medication highly effective at preventing HIV when taken as prescribed. Black women are disproportionately affected by HIV but are significantly underrepresented among PrEP users, according to Walcott.
“Black women face unique vulnerabilities to HIV, including systemic inequities and socioeconomic challenges, yet they are often overlooked in HIV prevention efforts,” Walcott said. “This study seeks to address those gaps through culturally relevant and community-centered interventions.”
Developing a community-centered intervention
The first phase of the study involves in-depth interviews with 25 Black cisgender women and 10 healthcare providers across New York State. The discussions aim to identify barriers and facilitators to PrEP access, with insights used to shape a tailored educational intervention.
The intervention will consist of four modules addressing key areas:
• HIV risk assessment: Helping women evaluate personal risk factors and partner-related risks.
• Gender norms and communication: Building skills to discuss prevention with healthcare providers and partners.
• PrEP education: Combating stigma and providing clear information about the medication.
• Financial literacy: Supporting stability and access to care through financial empowerment.
The program will include peer-led sessions delivered in person or online, based on participants’ preferences.
A holistic approach
Walcott’s research draws on lessons from her previous work in Alabama, where she studied the interplay of social factors such as poverty, stigma, and access to resources in shaping HIV outcomes. She emphasizes the importance of addressing systemic barriers alongside individual behaviors to create sustainable prevention strategies.
“Lack of transportation, housing instability, and limited job opportunities create a cycle that increases vulnerability to HIV,” Walcott explained. “Our intervention aims to empower women holistically by addressing these broader inequities.”
Walcott’s team is collaborating with community organizations, faith-based groups, and health providers to ensure the program reflects the lived experiences of its target population. Partners include the New York State Department of Health, the Alliance for Positive Health, and Callen-Lorde Community Health Center.
The impact
Once the intervention is finalized, its effectiveness will be assessed through a randomized controlled trial involving 160 Black cisgender women. The findings are expected to inform public health strategies and policy aimed at advancing health equity and reducing HIV disparities.
“This work is about more than preventing HIV,” Walcott said. “It’s about empowering women to take control of their health and ensuring they have access to the resources they need.”
