Congratulations to our 2022 pilot awardees - Drs. Melissa Ertl and Justin Knox!
Abstract
Although pre-exposure prophylaxis (PrEP) provides powerful prevention against HIV, low uptake and adherence threaten public health efforts to reduce HIV incidence among substance-involved Latinx adults who are at risk for HIV. Formative, community-based participatory research is necessary to better understand unique barriers, facilitators, and cultural factors related to their engagement in sexual health care and to identify potential efficacious strategies with this high-risk minoritized population. Guided by implementation science and health equity promotion frameworks, we will conduct in-depth qualitative interviews with 30 substance-involved Latinx adults at risk for HIV and 6 service providers and directors, recruited at three partner sites, to explore prospects and possibilities for implementing PrEP and sexual health services. Aims include to: (1) assess barriers to and facilitators of sexual health and preventive (including PrEP) behaviors; (2) identify cultural factors and syndemic influences involved in sexual decision-making to support the development of culturally responsive approaches; and (3) explore perceptions of best fit messaging, practices, settings, champions, and other essential elements for delivering PrEP and sexual health services with substance-involved Latinx adults. This pilot study will inform a K01 application aiming to use mixed methods to advance understanding of sexual health promotion in Latinx adults who use substances and inform the development of culturally responsive, affirmative strategies for implementing PrEP and sexual health services. This work furthers NIH HIV strategic goals, including using “implementation strategies to improve systematic uptake of evidence-based prevention, care, and treatment interventions in diverse settings and populations.”
Abstract
We propose a pilot study to collect preliminary data on how to adapt alcohol interventions for Black gay, bisexual and other sexual minority men (SMM), a population with a disproportionate burden of alcohol use and HIV, as well as how to deliver these interventions in HIV prevention and care settings. In order to achieve this, we will conduct in-depth interviews with journey mapping among 15 heavy-drinking Black SMM living with HIV and 15 heavy-drinking Black SMM at high-risk for HIV to understand their user experiences accessing and utilizing HIV prevention and care services. Journey mapping, a powerful tool from human centered design (HCD), will be used to elucidate salient pain points in the user journey and will inform the development of implementation strategies to improve the user experience and co-delivery of alcohol interventions and HIV prevention and care services. We will also conduct in-depth interviews with 10 implementation partners and collect input on feasibility of co-locating drinking reduction interventions into existing HIV prevention and care services. Collectively, we will use the findings from this research to inform the revision and re-submission of an R01 proposal to assess the effectiveness and implementation of a package of tailored drinking reductions interventions for Black SMM in the context of HIV prevention and care services.
