Center for HIV Identification, Prevention and Treatment Services (CHIPTS) - EHE Supp: Developing Implementation Strategies to Optimize PrEP Delivery to Immigrant Latino MSM in Los Angeles County

项目摘要：艾滋病毒对拉丁裔男男性行为者(LMSM)的影响不成比例，尤其是 移民。美国疾病控制与预防中心估计，LMSM的终身艾滋病毒风险为五分之一，而白人MSM的风险为十一分之一。 暴露前预防(PrEP)是一种在预防艾滋病毒方面高效的循证干预措施 收购，有可能减少移民LMSM中新感染艾滋病毒的人数。然而， 对移民LMSM实施PrEP等干预措施可能无法充分发挥其潜力，原因是 交付过程中的挑战和障碍。因此，制定适当和可行的执行 战略具有改善对这一人群的PrEP交付的潜力。这个规划项目的目标是 在探索、准备、实施、 可持续发展(EPIS)实施框架，以制定战略以解决提供PrEP过程中的不平等问题 给洛杉矶县(LAC)的LMSM移民。 本项目以国家防护柱为重点。 结束艾滋病毒流行(EHE)倡议，并与拉丁美洲和加勒比地区的EHE计划保持一致，以促进PrEP扩大工作和 减少准入和延续的门槛。 作为这个项目的第一步，我们将使用一个交叉式 审查污名化身份(即拉丁裔族裔、同性恋身份、移民)之间相互作用的框架 身份)和结构(无法获得医疗保健、制度化的同性恋恐惧症和耻辱)以了解 移民LMSM在获得卫生保健和艾滋病毒预防服务方面的经验，如PrEP。在……里面 我们的第二步，我们将使用社区参与的方法来制定实施策略，以优化 向移居的LMSM提供和采用PrEP。更具体地说，我们将使用概念映射 与拥有专业知识和/或工作经验的关键利益相关者小组合作的方法 与移民拉丁裔MSM(即服务提供者、艾滋病毒规划机构成员、社区倡导者) 共同解决向这一人群提供PrEP的障碍。通过概念映射过程， 专家小组将概念化和定义多种实施战略(例如，新的PrEP支持服务， 提供者培训和实践/政策的改变)，以加强对人口的PrEP交付。该小组还将 这个 预期成果包括由利益相关者和社区生成的概念模型和汇编 实施战略，加强向洛杉矶县移民LMSM提供和提供PrEP。我们 将与我们当地的艾滋病毒规划机构和社区合作伙伴分享研究结果，以供未来实施。 评价改善PrEP交付的实施战略的相对重要性和可行性。

PROJECT ABSTRACT: HIV disproportionately affects Latino men who have sex with men (LMSM), especially immigrants. The CDC estimates the lifetime HIV risk is 1 in 5 for LMSM compared to 1 in 11 for White MSM. Pre-Exposure Prophylaxis (PrEP) is an evidence-based intervention highly effective in preventing HIV acquisition, with the potential to reduce the number of new HIV infections among immigrant LMSM. However, implementation of interventions such as PrEP with immigrant LMSM may not reach their full potential due to challenges and barriers in delivery. As such, the development of appropriate and feasible implementation strategies holds the potential to improve PrEP delivery to this population. The goal of this planning project is to work within the “Exploration and Preparation” phases of the Exploration, Preparation, Implementation, Sustainment (EPIS) implementation framework to develop strategies to address inequities in delivery of PrEP to immigrant LMSM in Los Angeles County (LAC). This project focuses on the Prevent Pillar of the national Ending the HIV Epidemic (EHE) initiative and aligns with LAC's EHE plan to facilitate PrEP scale up efforts and reduce barriers to access and continuation. As a first step in this project, we will use an intersectional framework to examine the interplay between stigmatizing identities (i.e., Latinx ethnicity, gay identity, immigrant status) and structures (lack of access to healthcare, institutionalized homophobia and stigma) to understand the experiences of immigrant LMSM in accessing health care and HIV prevention services such as PrEP. In our second step, we will use community-engaged approach to develop implementation strategies to optimize delivery to and adoption of PrEP among immigrant LMSM. More specifically, we will use a concept mapping methodology to work with a panel of key stakeholders with expertise, knowledge and or experience working with immigrant Latino MSM (i.e., service providers, HIV planning body members, community advocates) to collectively address barriers to PrEP delivery to this population. Through the concept mapping process, the panel will conceptualize and define multiple implementation strategies (e.g., new PrEP support services, provider training, and change in practice/policy) to enhance PrEP delivery to the population. The panel will also The expected outcomes include a conceptual model and compilation of stakeholder- and community-generated implementation strategies to enhance access to and delivery of PrEP to immigrant LMSM in LA County. We will share the findings with our local HIV planning body and community partners for future implementation. rate the relative importance and feasibility of the implementation strategies to improve PrEP delivery.