Southeast Collaborative for Innovative and Equitable Solutions to Chronic Disease Disparities

摘要-Bon Bagay(好东西)：海地裔人中的生物医学艾滋病毒预防 艾滋病毒是一种慢性病。佛罗里达州的迈阿密是美国艾滋病毒发病率最高的城市之一。 国家1以前来自迈阿密的数据显示，海地出生的人占报告的艾滋病毒总数的11% 病例，尽管只占人口的4.4%。2 居住在迈阿密的海地后裔缺乏获得或接受艾滋病毒预防服务的机会。 暴露预防(PrEP)是预防新的艾滋病毒感染的有效方法。 PrEP利用率方面的差异。在美国，有艾滋病毒风险的黑人个人不会像 与白人相同的情况下，5和PrEP的使用在海地后裔中甚至更不常见。 之前的研究是在迈阿密进行的，对携带艾滋病毒的海地后裔进行了研究，然而，这些 研究没有包括生物医学艾滋病毒预防战略，如PrEP.6，7由 Sternberg博士(Bon Sante或Good Health研究)发现，人们对PrEP的使用非常感兴趣，但缺乏 8此外，教堂作为提供初级教育方案信息和信息的途径 注意到可能的交付。8本申请的目的是： 目标1：描述实施PrEP的背景和组织决定因素，以及 在迈阿密为海地后裔服务的教堂的可持续性。理论基础：在文化发展方面 克服海地人民现有差距(PrEP吸纳)的相关实施办法 因此，了解教会的组织文化、管理支持和目标是至关重要的 服务人群，重点放在PrEP交付上。研究方法：本研究将采用注重背景的研究方法 对于实施，实际、稳健的实施和可持续发展模型(PRISM)。9本研究将使用 棱镜来评估教会的观点。我们将通过举办焦点小组来关注交付的背景 与领导、经理和员工在一起。我们将利用在迈阿密建立的社区伙伴关系(海地人 美国专业人士联盟)招募焦点小组参与者。将开展三个重点小组，使用 半结构化面试指导，并将采用定性分析进行分析。结果：从这个目标出发，我们 将进一步了解教会的需求和决定因素，以便有效地提供预习课程。 目标2：量化海地后裔对PrEP的主要偏好。基本原理：离散型选择 实验已被广泛用于进一步了解个体对广泛的 服务和产品，包括PrEP10。我们将使用此方法对有关PrEP交付的首选项进行排名 并在迈阿密参加教堂的海地后裔中打字。方法：我们将进行一次离散的 在120名居住在迈阿密的海地裔人中进行的选择实验，以评估他们的偏好 在关键属性中。结果：通过这个过程，我们将有一个描述关键的定量发现 PrEP的可取属性及其对参加教堂的海地社区成员的规定。

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.