PrEP Implementation Tailored for Mississippi Community Health Clinics

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Administrative Supplement Abstract: This proposed project will extend our ongoing implementation science research in telemedicine for PrEP in non-medical community-based organizations (CBOs) by forming new partnerships with the Aaron E. Henry Community Health Services Center (Aaron Henry) and the Jackson - Hinds Comprehensive Health Center (Jackson - Hinds). These Centers, with their many community health clinics (CHCs), provide primary health care services to poor, uninsured, and under-served population in the state. This research will expand PrEP and HIV prevention services to decrease the risk for HIV transmission in geographic locations identified by the Ending the HIV Epidemic initiative. There is considerable data on methods and strategies (e.g. telemedicine, PrEP navigators, provider training) to successfully increase use of PrEP, but little information on how these methods should be selected and tailored for CHCs. Effective expansion of PrEP services requires careful assessment of the needs, staff, and context of the relevant healthcare organization. Fortunately, Implementation Science (IS) provides the framework needed for the successful implementation of PrEP at CHCs. This project is a natural extension of ongoing, collaborations at the University of Mississippi Medical Center (UMMC), the Mississippi Department of Health, and CBOs. Our team has experience developing and testing interventions to improve engagement and adherence to PrEP and other relevant HIV projects among adults, youth, and sexual minorities. Importantly, the parent grant, “Telemedicine for PrEP throughout Mississippi: Tele-PrEP-MS” (R34 MH115744, mPIs: Brown & Mena) has provided us with experience in using an IS framework to collect formative interview data, tailor protocols, deliver trainings, provide ongoing technical assistance, and assess the outcomes of a PrEP implementation intervention. However, this experience has been in non-medical community-based organizations that do HIV testing, and not in CHCs like those run by the Aaron Henry and Jackson - Hinds centers. This project will allow for the greatly needed expansion of PrEP services to CHCs that deliver primary care in MS, and we will utilize best scientific practices to guide this expansion.