Project Details
Description
ABSTRACT
Black and Latinx sexual minority men (BLSMM) in the Bronx, NY and in the U.S. overall are among the
populations most impacted by HIV in both Bronx, NY and in the U.S. BLSMM are impacted by multiplel
barriers, including medical mistrust, multiple stigmas, and limited health care access, which intersect to
cumulatively increase HIV risk and negatively impact access to pre-exposure prophylaxis (PrEP). Improving
access to and use of PrEP requires care delivery strategies tailored to the unique needs and circumstances of
BLSMM. There is broad consensus that addressing disparities impacting BLSMM and ending the HIV epidemic
requires creative, community-engaged, participatory approaches. One such approach is system dynamics
modeling, an action research methodology to identify practicable, effective solutions to complex problems by
examining both the dynamic relationships between their underlying factors and the potential impact of
interventions to address these problems. In the proposed study, together with a diverse, Bronx-based group of
community and implementer stakeholders, we will undertake a system dynamics-informed implementation
mapping process to identify promising PrEP implementation strategies. This work will be guided by two
implementation science frameworks: the Consolidated Framework for Implementation Research (CFIR) and
Proctor’s Taxonomy of Implementation Outcomes. In the R21 phase of this proposal, we aim to: (1) co-design
and validate a system dynamics model delineating factors influencing PrEP engagement for BLSMM, and (2)
use the resultant model to determine the potential effectiveness of one or more prioritized strategies to improve
PrEP engagement. If we achieve pre-specified R21 milestones, in the R33 phase, our specific aim is to: (3)
pilot test the most promising strategies, working with stakeholders to operationalize and implement the
strategies and measure their impact. The findings from this participatory, community-engaged study will
provide timely and practical data that will advance our understanding of how to reduce disparities in PrEP
uptake and ultimately HIV transmission rates for BLSMM.
Status | Active |
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Effective start/end date | 9/1/24 → 8/31/25 |
Funding
- NATIONAL INSTITUTE OF MENTAL HEALTH: $252,000.00
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