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：艾滋病毒对与男性发生性关系的拉丁裔男性（LMSM）的影响不成比例，特别是 移民. CDC估计LMSM的终生艾滋病毒风险为1/5，而白色MSM为1/11。 暴露前预防（PrEP）是一种有效预防艾滋病毒的循证干预措施 艾滋病毒感染者，有可能减少移民LMSM中新的艾滋病毒感染人数。然而，在这方面， 对移民LMSM实施PrEP等干预措施可能无法充分发挥其潜力， 交付方面的挑战和障碍。因此，制定适当和可行的执行办法， 这些战略有可能改善向这一人群提供PrEP的情况。该规划项目的目标是 在探索、准备、实施的“探索和准备”阶段工作， 可持续发展（EPIS）实施框架，以制定战略，解决PrEP提供中的不公平问题 洛杉矶县（LAC）的移民LMSM。 该项目的重点是国家预防犯罪支柱， 结束艾滋病毒流行病（EHE）倡议，并与拉丁美洲和加勒比的EHE计划保持一致，以促进PrEP扩大工作， 减少获取和继续使用的障碍。 作为这个项目的第一步，我们将使用一个交叉 框架，以审查污名化的身份之间的相互作用（即，拉丁裔，同性恋身份，移民 地位）和结构（缺乏获得医疗保健的机会，制度化的同性恋恐惧症和耻辱），以了解 移民LMSM在获得医疗保健和艾滋病毒预防服务（如PrEP）方面的经验。 我们的第二步，我们将采用社区参与的方法来制定实施战略，以优化 在移民LMSM中提供和采用PrEP。更具体地说，我们将使用概念映射 与具有专业知识、知识和/或工作经验的关键利益攸关方小组合作的方法 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， 小组将概念化和定义多个实施策略（例如，新的PrEP支持服务， 提供者培训，以及实践/政策的变化），以加强向人口提供PrEP。专家小组还将 的 预期成果包括一个概念模型和利益攸关方和社区产生的 实施战略，以提高获得和提供PrEP移民LMSM在洛杉矶县。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调查结果，以便将来实施。 评估实施战略的相对重要性和可行性，以改善PrEP的交付。

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.