Puerto Rico PrEParado: Increasing PrEP uptake among sexual minority men in Puerto Rico

摘要 在波多黎各，性少数男性（SMM）的暴露前预防（PrEP）使用率非常低。虽然 PrEP的认识和吸收继续在美国（US）周围增加，SMM的大部分在 波多黎各艾滋病毒风险增加的人仍然不知道PrEP是一种艾滋病毒预防策略。扩大使用 为服务不足的人群提供PrEP和优化PrEP提供是结束艾滋病的关键战略之一。 艾滋病毒流行病倡议（EHE），证据表明，PrEP吸收与 艾滋病毒感染率下降。尽管如此，PrEP的实施面临许多障碍，包括认识和 潜在用户和医疗保健提供者的可接受性。为了填补研究空白， 了解和减少障碍，以实现PrEP吸收之间的高影响组（SMM）和 为了响应EHE的号召，我们提出了以下目标：1）系统地评估障碍， 在波多黎各艾滋病毒/性传播感染诊所中促进艾滋病毒检测与PrEP意识和吸收之间的联系 Rico; 2）制定波多黎各PrEParado，这是一项针对艾滋病毒/性传播感染检测诊所的政策干预措施，以优化PrEP 3）在一个艾滋病毒/性传播感染检测诊所试行波多黎各预防艾滋病毒/性传播感染政策干预 评估实施结果和对波多黎各SMM中PrEP吸收的潜在影响。 这项研究的结果和发现将有助于推进EHE努力，以改善PrEP的可及性， 波多黎各和其他拉丁裔人口的SMM。

ABSTRACT Pre-Exposure Prophylaxis (PrEP) use among sexual minority men (SMM) in Puerto Rico is notably low. Although PrEP awareness and uptake continue to increase around the United States (US), large proportions of SMM at increased risk for HIV in Puerto Rico are still unaware of PrEP as an HIV prevention strategy. Expanding the use of PrEP to underserved populations and optimizing PrEP delivery is one of the key strategies of the Ending the HIV Epidemic Initiative (EHE), as evidence has shown a significant association between PrEP uptake and a decline in HIV incidence. Nonetheless, PrEP implementation faces many barriers including awareness and acceptability among potential users and health care providers. In order to fill the research gap aimed to understand and reduce the barriers to achieve PrEP Uptake among a high impacted group (SMM) and in response to the call of the EHE, we propose the following aims: 1) to systematically assess the barriers and facilitators for the linkages between HIV testing and PrEP awareness and uptake in HIV/STI clinics in Puerto Rico; 2) to develop Puerto Rico PrEParado, a policy intervention for HIV/STI testing clinics to optimize PrEP uptake among SMM; and 3) to pilot the Puerto Rico PrEParado policy intervention in one HIV/STI testing clinic to assess implementation outcomes and the potential impact on PrEP uptake among SMM in Puerto Rico. Results and findings from this research will help advance the EHE efforts to improve the access to PrEP among SMM in Puerto Rico and other Latino populations.