Pre-exposure Prophylaxis (PrEP) for People Who Inject Drugs (PWID)

People who inject drugs (PWID) experience high risk of HIV acquisition. Antiretroviral pre-exposure prophylaxis (PrEP) is an efficacious biomedical HIV prevention strategy for high risk HIV-uninfected individuals including PWID, yet uptake has been low in this population and uptake and adherence interventions have not been developed or tested. Drawing from formative qualitative research, the overall goal of this project is to develop an intervention to promote PrEP uptake and adherence among PWID in the U.S. Northeast. The investigators will: * Analyze existing literature and data to identify specific barriers and facilitators to PrEP uptake and adherence among PWID to inform the initial adaptation of existing theory-based interventions; * Conduct qualitative interviews with \~30 PWID and \~10 key informants (PrEP and other clinical and social service providers) to identify intervention targets; * Develop and iteratively refine and finalize an intervention manual based on feedback from qualitative exit-interviews with an interventionist and \~10 PWID; and * Conduct a pilot randomized clinical trial (RCT) in \~50 HIV-uninfected PWID to compare PrEP uptake and adherence outcomes and assess intervention feasibility and acceptability.