SOMOS Alianza: Developing a Strategic Alliance across Three HIV Epicenters to Achieve Ending the HIV Epidemic Goals among Latino MSM

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Project Summary Florida (FL) and Puerto Rico (PR) were two of seven jurisdictions accounting for 84% of the national increase in HIV incidence among Latino MSM from 2010-2014. Fueling the problem, evidence-based HIV-prevention and treatment interventions for Ending the HIV Epidemic (EHE) are insufficiently scaled up in both regions. For example, in PR, only 5.7% of PrEP eligible Latino MSM were taking it. In addition to similar disparities across FL and PR HIV epicenters (i.e., Miami Dade County/MDC, Orlando/Orange County, San Juan Municipio), there is significant migration between these epicenters, suggesting the utility of forming a strategic alliance and sharing interventions and implementation strategies across jurisdictions to achieve EHE goals. Accordingly, the aims of this project are as follows: Aim 1: Form a strategic alliance between three EHE jurisdictions tied by migration and within which LMSM experience HIV disparities. We will form a strategic alliance – SOMOS Alianza – between MDC, Orange County, and San Juan. The significance of this partnership is underscored by (1) all jurisdictions being EHE priorities, (2) similar HIV disparities among LMSM in all jurisdictions, and (3) migration between jurisdictions. Aim 1 will involve establishing, engaging, and monitoring outcomes of the alliance. Engagement activities will involve in-person and virtual meetings guided by network weaving (an implementation strategy) to set goals, identify assets and strengths in each jurisdiction that could be translated to other jurisdictions, and speed networking/matchmaking to promote connections, scaling out innovations, and developing new implementation research and practice projects. We will monitor outcomes of alliance membership. The alliance will include implementation (e.g., Florida DOH, Puerto Rico GCAP, and FQHCs), community (individuals with lived experience), and scientific partners. Aim 2: Leverage the strategic alliance to adapt our implementation strategy (JUNTOS Referral Network) for scaling up HIV-prevention and treatment services to LMSM to two new jurisdictions. We will leverage the strategic alliance from Aim 1 to adapt the JUNTOS Referral Network which we are developing for MDC, to be usable in San Juan and Orange County as well. We will use ADAPT-ITT1,2 to carry out the adaptation. Using theater testing, we will show alliance members from San Juan and Orange County the MDC prototype of JUNTOS. They will describe modifications to make JUNTOS acceptable, appropriate, and feasible (Proctor's implementation outcomes) for use in San Juan and Orange County. Their feedback will inform adapted prototypes of JUNTOS. Collectively, Aims 1 and 2 will add value by (1) creating a strategic alliance between EHE priority jurisdictions to achieve EHE goals and (2) leveraging the alliance for one specific adaptation project. These activities will further EHE goals as well as lay the foundation for a multi-site R01 implementation-science focused research study testing the utility of JUNTOS for improving implementation and increasing LMSM demand for HIV-prevention and treatment services, aligned with EHE priorities.