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

摘要 在波多黎各的性少数族裔男性(SMM)中，暴露前预防(PrEP)的使用率明显较低。虽然 美国各地(美国)的预科意识和接受继续增加，很大比例的SMM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战略。扩大使用范围 将PrEP推广到服务不足的人群，优化PrEP的交付是结束 艾滋病毒流行倡议(EHE)，因为有证据表明PrEP的吸收和 艾滋病毒发病率下降。尽管如此，PrEP的实施面临着许多障碍，包括认识和 潜在使用者和卫生保健提供者的可接受性。为了填补研究空白，旨在 了解并减少在受影响较高的群体(SMM)和 响应EHE的号召，我们提出了以下目标：1)系统地评估障碍和 波多黎各艾滋病毒/性传播感染诊所艾滋病毒检测与PrEP认识和接受之间联系的促进者 波多黎各；2)为艾滋病毒/性传播感染检测诊所制定一项政策干预措施，以优化PrEP 3)在一家艾滋病毒/性传播感染检测诊所试行波多黎各准备政策干预 评估执行成果和对波多黎各SMM接受PrEP的潜在影响。 这项研究的结果和发现将有助于推动EHE的努力，以改善获得PrEP的机会 波多黎各和其他拉美裔人口中的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.