STUDY PROTOCOL article
Front. Med.
Sec. Obstetrics and Gynecology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1521455
This article is part of the Research TopicAdvancing HIV Treatment and Prevention for Cisgender Women: Approaches to Optimize Health OutcomesView all 9 articles
Leveraging Public Health Infrastructures to Support Sexual Health for Women Living in the Southern United States
Provisionally accepted
Madeline C. Pratt1*
Tammi F. Thomas1Anthony Merriweather2Caroline Deaterly1Bernadette Johnson1Lisa Hightow-Weidman3Kathleen W Hurwitz4
Kara Bennett4Nuvan Rathnayaka4
Henna Budhwani3Aadia Rana1Ariann Nassel5
Latesha Elopre1
Lynn Turner Matthews1- 1Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, United States
- 2Alabama Department of Public Health, Montgomery, Alabama, United States
- 3College of Nursing, Florida State University, Tallahassee, Florida, United States
- 4Target RWE, Durham, California, United States
- 5Lister Hill Center for Health Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, United States
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Background: Camellia is a single-arm longitudinal cohort study. We engaged a Community Advisory Board to support refinement of an existing mHealth app platform for use among cis- and transwomen in Alabama, one of seven states prioritized in the federal Ending the HIV Epidemic (EHE) strategy. We partnered with the Alabama Department of Health to recruit from a database of women recently diagnosed with gonorrhea or syphilis, aged 18-50, across Alabama. Potential participants are recruited by telephone. A home-based HIV and sexually transmitted infection (STI) testing program allows the program to offer tailored sexual health information, testing, linkage to care and support while assessing STI and HIV incidence and associated predictors. Methods: Study participants are enrolled into the digital Camellia Cohort in which they complete home-based HIV and STI testing and online surveys every 6 months. Participants are followed for at least 24 months or until study completion (up to 42 months). Primary outcomes include predictors, mediators and moderators for HIV and STI incidence and pre-exposure prophylaxis (PrEP) use via self-report, medical record review, and dried blood spots. Conclusion: The Camellia Cohort integrates epidemiologic methods, mHealth technology, and data science to better characterize HIV transmission dynamics and engagement in the prevention care cascade among women in an EHE focus state. This study will provide critical insights into the feasibility and acceptability of a remote, light-touch cohort design, while also providing data on STI and HIV incidence, PrEP use, and key mediators and moderators influencing prevention behaviors among women with indications for PrEP in this high-priority region.
Keywords: hiv prevention, Women, Deep South, Alabama, cohort, sti, HIV
Received: 01 Nov 2024; Accepted: 11 Aug 2025.
Copyright: © 2025 Pratt, Thomas, Merriweather, Deaterly, Johnson, Hightow-Weidman, Hurwitz, Bennett, Rathnayaka, Budhwani, Rana, Nassel, Elopre and Matthews. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Madeline C. Pratt, Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, United States
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.