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For adolescent girls and young women in sub-Saharan Africa, HIV prevention is not simply a matter of medical access. It is shaped by stigma, gender norms, family dynamics, provider attitudes, transportation barriers, health policy, and whether a prevention tool fits the realities of daily life.

That is where research led by 17�Թ��� College of Health Professions faculty members Erica L. Gollub, DrPH, MPH, professor of health science, and Marie Lourdes Charles, EdD, RN-BC, FNYAM, associate professor of nursing, are making an important contribution. Their work highlights two essential forces in global : health care providers as the bridge between innovation and access, and global research rooted in meaningful local partnerships.

Their study, “‘Some people fear injection and others don’t want to swallow tablets, while others forget’: Health care provider perspectives on the PrEP (dapivirine) ring in rural Uganda (‘ProPrEP’),” examines how health care providers understand and respond to the dapivirine vaginal ring (DVR), a monthly, user-controlled HIV prevention method. The full research team includes Gollub and Charles of 17�Թ���; Esther Nakyaze of ; and Drs. Marc Sklar and Murokora Daniel of .

Adolescent girls and young women are central to this study because they remain among the populations most disproportionately affected by HIV. In sub-Saharan Africa, they account for more than 60 percent of adults living with HIV, and one in four new HIV infections occurs among women ages 15–24, despite the fact that they make up only 10 percent of the population. In Uganda, that gender disparity is especially clear: HIV prevalence among young women ages 15–24 is 2.9 percent, compared with 0.8 percent among young men. Those numbers underscore why prevention tools must be designed not only to work medically, but also to fit the social, cultural, and practical realities of young women’s lives. 

“The research that we do anywhere is going to support women getting access to HIV tools everywhere."

Charles and Gollub recently presented their work as part of 17�Թ���’s annual conference hosted by the Office of Research and Graduate Education, an opportunity to share research that sits at the intersection of public health, nursing, global health equity, women’s autonomy, and implementation science. 

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The study focused on 60 health care providers in the Rakai and Kyotera districts of rural Uganda, including nurses, midwives, and community health workers. Through focus group discussions, the researchers explored provider perspectives on the DVR’s potential benefits, barriers to use, and the education needed to support adolescent girls and young women.

For Gollub, who has spent decades working in HIV prevention, the urgency is clear.

“HIV prevention needs are critical among the population of adolescent girls and young women worldwide, but particularly in sub-Saharan Africa,” she says. “It’s one thing to have tools and medications to prevent HIV infection. It’s another thing to be able to have them be used.”

The distinction between availability and real-world use is at the heart of the research. In public health, innovation only matters when people can access it, trust it, and use it. The DVR offers a discreet, nonhormonal option that women can insert themselves and use for one month at a time. Because it is not a daily pill, does not require frequent injections, and can be used privately, providers in the study see strong potential for the ring to reduce stigma and expand prevention options.

Gollub describes the ring as “revolutionary,” particularly because it gives women a prevention option that is largely in their own hands.

“It does put control in the hands of women for the very first time in a really meaningful way,” she says.

That control matters. Both Gollub and Charles emphasize that women’s HIV risk is often tied to broader issues of power, autonomy, and gender inequality. In many contexts, young women may not be able to negotiate condom usage, openly seek sexual health services, or disclose that they are using HIV prevention.

Charles notes that provider buy-in is especially important in communities, particularly patrilineal ones, where health care workers hold significant authority and power. In that sense, providers are not simply delivering a new method, they are the bridge between a promising biomedical innovation and the women who may benefit from it.

“You’re talking about a society that does not question authority,” she says. “Therefore, if the provider does not embrace the treatment, they will not pass it on.”

The study finds that providers are enthusiastic about the ring as an additional HIV prevention option, particularly because it may address some barriers associated with existing PrEP methods. Providers cite concerns that some people fear injections, others dislike swallowing tablets, and others forget to take daily pills. They also see the ring’s privacy as a major advantage for young women who may fear stigma from partners and parents, or community members as a whole.

At the same time, providers identify real implementation challenges, including community misconceptions, partner resistance, supply issues, policy barriers around sexual health education, and the need for provider training. The study also finds that male involvement is critical. Although the ring may offer women more autonomy, providers emphasize that educating men and gaining their support could help reduce resistance and improve uptake.

“One thing that came out was that we need men. We need their buy-in,” Charles says. “No matter how we circle it, how we approach it, men still have a say in this conversation.”

That insight reflects the complexity of global public health work: successful uptake requires more than a product. It requires trust, education, cultural awareness, and partnership. The research shows that health care providers can play a pivotal role in translating scientific progress into community-level impact.

“One thing that came out was that we need men. We need their buy-in,” Charles says. “No matter how we circle it, how we approach it, men still have a say in this conversation.”

The project also demonstrates the strength of interdisciplinary collaboration at 17�Թ���’s College of Health Professions. Gollub brings expertise in HIV/AIDS epidemiology and public health, while Charles brings deep experience in nursing, community health, and global health education. Together, they partnered with Babies and Mothers Alive Foundation, a Ugandan-led organization focused on reproductive, maternal, and newborn health.

That local partnership was central to the project’s success. Rather than approaching the work as outside researchers entering a community, collecting data, and leaving, the 17�Թ��� faculty collaborated with partners who understood the local health system, the providers, and the communities involved.

“We really worked with an ongoing collaboration with that site,” Gollub says. “We all put in different skills, and we  made this wonderful mosaic.”

Charles describes the experience as a learning opportunity on both sides.

“In the process, we learn what it takes to do global study,” she says. “Each side learned something.”

That collaborative approach is central to the impact of the work. By listening to providers already embedded in local health systems, the research identifies practical steps that could improve training, counseling, outreach, and policy as the PrEP ring becomes more widely available. 

The implications extend beyond Uganda. As Gollub notes, research in one setting can inform HIV prevention for women globally, including in the United States.

“The research that we do anywhere is going to support women getting access to HIV tools everywhere,” she says.

For 17�Թ���, the study is a powerful example of faculty research that connects public health innovation with real human need. It reflects CHP’s commitment to socially responsive, globally minded health education and to preparing health professionals who understand that improving care means understanding people, communities, and systems.

Charles puts the global stakes simply: “What happens to your neighbor eventually happens to you.”

Through their work, Charles and Gollub are helping ensure that more women have access not only to HIV prevention tools, but also to choices, information, and support. In global health, that is a major win.