Chapel Hill, N.C. — Researchers at the UNC Institute for Global Health and Infectious Diseases recently held a launch retreat for a new study testing ways to connect women leaving prison with highly effective HIV prevention tools, including pre‑exposure prophylaxis (PrEP). Led by Becky White, MD, MPH, infectious diseases physician and long‑time HIV clinician, the project focuses on women incarcerated at the North Carolina Correctional Institution for Women in Raleigh who will be released to Guilford County.
Women involved in the criminal justice system face disproportionately high risk for HIV and often have limited access to biomedical prevention, particularly during the first year after release, when they are navigating unstable housing, employment, transportation, family reunification, and recovery from substance use.
“We already know that PrEP works,” said Dr. White. “The real question is whether we can build a system that actually helps women leaving prison get connected to and stay engaged in HIV prevention care during one of the most difficult times in their lives.”
The feasibility study is designed to understand what it takes in the real world to make HIV prevention accessible to women leaving incarceration. In the initial phase, the team will recruit a small group of women in the state women’s prison who are at risk for HIV and will be released to Guilford County, provide education about HIV, PrEP, and post‑release challenges, and refine recruitment strategies, educational materials, and data collection tools in partnership with participants and the prison system. A subsequent phase will enroll a larger group of women to test an intervention that begins before release and continues afterward, connecting them to community health workers and community health clinics that can provide PrEP.
The model builds on the North Carolina Formerly Incarcerated Transition (NC FIT) Program, led by Family Medicine, which has successfully linked people leaving prison to primary care, substance use treatment, and mental health services. Dr. White’s team will test whether this navigation model can be adapted specifically for PrEP and HIV prevention services in already resource‑stretched clinics.
“Clinics are already working at full capacity,” Dr. White said. “We want to know if this kind of HIV prevention program is truly feasible for women, for the prison system, and for community health centers.”
The study is a collaboration between UNC-Chapel Hill, NC A&T State University, and the University of Georgia, working closely with the North Carolina prison system, the NC FIT Program, and community health centers in Guilford County. Key collaborators include Zahra Khalaf, PhD, associate professor of psychology, NC A&T, specializing in qualitative and sexual health research; and Sharon Parker, PhD, MSW, associate professor of social work at the University of Georgia, with extensive experience in HIV prevention in criminal justice settings.
For Dr. White, the project grows directly out of years of caring for women with HIV. “Having seen so many women with HIV throughout the years and watching so many women suffer, I am determined—if we can—to prevent suffering, to prevent disease and prolong life,” she said.
“For decades, I’ve seen the toll HIV takes on women and families,” said Dr. White. “If we can prevent new infections and reduce preventable suffering, we can change the trajectory not only for individual women, but for their children and communities.”
About the UNC Institute for Global Health and Infectious Diseases
The UNC Institute for Global Health and Infectious Diseases brings together clinicians, scientists, and partners around the world to prevent and treat infectious diseases through innovative research, clinical care, and training. The Institute’s work spans HIV, emerging infections, global health partnerships, and implementation science that translates proven interventions into real‑world impact.