Southeast Collaborative for Innovative and Equitable Solutions to Chronic Disease Disparities

点击翻译按钮获取中文摘要

SUMMARY- Bon Bagay (Good Stuff): Biomedical HIV Prevention Among People of Haitian Descent HIV is a chronic disease. The city of Miami, Florida has one of the highest incidence rates of HIV in the United States.1 Previous data from Miami showed that Haitian-born people represented 11% of the total reported HIV cases, despite comprising only 4.4% of the population.2 A likely cause for the disparity in HIV incidence among people of Haitian descent living in Miami is a lack of access to or uptake of HIV-preventive services.3 Pre- exposure prophylaxis (PrEP) is an effective method to prevent new HIV infections.4 There are, however, vast disparities in PrEP utilization. Black individuals in the US at risk for HIV are not accessing these medications as frequently as their White counterparts,5 and PrEP use is even less common among people of Haitian descent. Previous research was conducted in Miami, among people of Haitian descent living with HIV, however, these studies have not included biomedical HIV prevention strategies such as PrEP.6,7 Preliminary work conducted by Dr. Sternberg, (the Bon Sante or Good Health study), identified a strong interest in PrEP use but a lack of culturally appropriate and accessible PrEP services.8 In addition, churches as avenues for PrEP information and potentially delivery was noted.8 The aims for this application are: Aim 1: To characterize contextual and organizational determinants of PrEP implementation and sustainability at churches serving people of Haitian descent in Miami. Rationale: In developing culturally relevant implementation approaches that overcome existing gaps (PrEP uptake) among people of Haitian descent, it is critical to understand the organizational culture, management support, and goals of churches serving the population, with a focus on PrEP delivery. Approach: This study will use a context-focused approach to implementation, the Practical, Robust Implementation and Sustainability Model (PRISM).9 This study will use PRISM to assess the churches' perspectives. We will focus on the context of delivery by conducting focus groups with leaders, managers, and staff. We will use an established community partnership in Miami (the Haitian American Professionals Coalition) to recruit focus group participants. Three focus groups will be conducted using semi-structured interview guides and will be analyzed using qualitative analysis. Outcome: From this aim, we will have a further understanding of the churches' needs and determinants for effective PrEP delivery. Aim 2: To quantify key preferences for PrEP among people of Haitian descent. Rationale: Discrete choice experiments have been widely used to further understand individual preferences regarding a wide range of services and products, including PrEP10. We will use this approach to rank preferences regarding PrEP delivery and type among people of Haitian descent in Miami attending church. Approach: We will conduct a discrete choice experiment among 120 people of Haitian descent living in Miami attending church to assess preferences among key attributes. Outcome: Through this process, we will have a quantitative finding describing critical desirable attributes of PrEP and its provision for members of the Haitian community who attend church.