USAID: Canceled HIV Studies Delay PrEP Research for Women

A USAID award termination in early-2025 ended Project Engage, a research effort led by CONRAD at Old Dominion University to improve oral PrEP adherence among adolescent girls and young women. The project supported three connected studies:

1. a comparative study of oral PrEP adherence patterns among adolescent girls and young women in South African and Zimbabwe;
2. an evaluation of a smartphone app providing daily adherence reminders and education in South Africa; and
3. a US-based evaluation of point-of-care adherence tests for antiretroviral drugs, including urine-based diagnostics and an emerging blood-based test developing in house.

At the time of the stop work order, participant follow-up for all three studies had been completed, but the team was unable to analyze and report results on schedule. With funding and support from Gilead, who was a co-funder of projects, researchers expect to be able to complete analysis and publish results, but the termination delayed progress significantly and ended the project about eight months early, eliminating approximately $1.3 million in remaining support. The result is delayed evidence with important implications for guiding clinical practice, improving PrEP adherence for young women at high risk of HIV, and strengthening ongoing US-funded HIV programs.

Beyond the scientific losses, the termination contributed to broader staffing and financial strain at CONRAD, which has reduced its staff by nearly 30 percent even with the university stepping in directly to provide additional financial support.

Partners: Florida State University (Tallahassee, FL); University of North Carolina (Chapel Hill, NC); University of Colorado (Aurora, CA), University of Washington (Pullman, WA); and Gilead (headquartered in Foster City, CA)