Implementation barriers and opportunities to optimize HIV testing and PrEP delivery among YMSM in Philadelphia.
The successful implementation of PrEP among young MSM populations will require us to understand the multilevel barriers linked to the PrEP continuum (e.g., awareness, willingness, access, retention, and adherence) in their communities. Beyond awareness and motivations, structural and agency-level characteristics can create obstacles and/or opportunities for PrEP-continuum engagement. YMSM must have access to comprehensive HIV prevention approaches (CHPA) services in institutions where they can be tested routinely, discuss whether PrEP is right for them with a trustworthy provider, receive a PrEP referral, and other risk reduction services. HIV test counselors have the greatest contact with YMSM in their day-to-day duties and could support YMSM as they navigate their engagement with PrEP services. To address the potential of HIV test counselors as integral members in PrEP delivery services, the current study will be a formative multilevel mixed-methods study exploring agencies’ perceived capacities to facilitate and address YMSM’s barriers to PrEP engagement in Philadelphia.
In partnership with the Philadelphia Department of Public Health as well as the University of Pennsylvania Center for AIDS Research (CFAR), the aims of the study are:
To examine PDPH-funded HIV test counselors' (N=120) information, motivation, and behavioral skills regarding PrEP delivery and counseling through a biannual web-survey;
To describe via focus groups and in-depth interviews the structural and organizational contexts that facilitate or hinder PrEP delivery for YMSM;
To triangulate these data to propose multilevel interventions focused on reducing barriers to the PrEP engagement continuum among urban YMSM living in Philadelphia.