De-Medicalizing PrEP by Partnering with House and Ball Community Using Social Work and Guiding Principles: Prioritizing Young Black LGBTQ+ Individuals

摘要 拟议的研究与“ 以注重公平的办法减少与艾滋病毒有关的健康 差距”， 将涉及《结束艾滋病毒流行病：美国计划》的“预防”支柱。 尽管有迹象表明，美国新的艾滋病毒感染正在趋于稳定，但年轻的黑人LGBTQ+个人 这些人的新感染率继续攀升。我们在这方面的重大差距 了解在这一优先事项中成功进行暴露前预防（PrEP）的障碍 这进一步阻碍了我们预防艾滋病毒感染的能力。House & Ball社区（H&BC） 几十年来，艾滋病毒流行病的影响尤为严重。H&BC提供了一个独特的机会， 通过有意义的伙伴关系采取以公平为重点的方法，以加强PrEP护理的连续性，包括 年轻的黑人LGBTQ+个人生活经验。此外，艾滋病毒/艾滋病涉及所有领域，包括心理健康领域。 健康、成瘾、社区发展和医疗保健。凭借他们在提供心理和 环境支持以及他们在建立服务联系和参与 社会工作者一直站在努力改善感染者生活的最前沿， 受艾滋病影响。这一领域的社会工作实践提供了一个支持年轻黑人的机会。 LGBTQ+个人与H&BC合作。 利用健康公平实施框架和社区合作的前瞻性研究 （CPPR）涉及学术机构（UCLA CHIPTS）和社区合作伙伴（ AMAAD研究所），拟议的研究将促进当地值得信赖的社会工作提供者的参与 机构和社区卫生中心发展 评估非医疗化社会工作的有效性 社区参与战略 .拟议的研究将在两年内分三个阶段进行。具体 拟议研究的目的是： 目标1：检查影响年轻黑人LGBTQ+中PrEP护理连续性的障碍和挑战 House & Ball社区（H&BC） 目标2：将H&BC赋权服务正规化，以促进与支持和留用服务的联系 由综合社会工作和基层参与机构提供;以及 目标3：试点测试以公平为重点、社区参与的基层模式方法，以支持PrEP 为H&BC的年轻黑人LGBTQ+成员提供连续照顾。

Abstract The proposed study is aligned with the topic “ Equity-focused approaches to reduce HIV-related health disparities” and will address the `Prevent' pillar of the Ending the HIV Epidemic (EHE): A Plan for America. Despite indications that new HIV infections in the United States are plateauing, young Black LGBTQ+ individuals are disproportionately affected, for whom the rates of new infection continue to climb. Critical gaps in our understanding of the barriers to successful pre-exposure prophylaxis (PrEP) engagement among this priority group further hinders our ability to prevent HIV infections. The House & Ball Community (H&BC) has been disproportionately affected by the HIV epidemic for decades. The H&BC provides a unique opportunity to apply an equity-focused approach through meaningful partnership to enhance the PrEP care continuum to include young Black LGBTQ+ individuals with lived experience. In addition, HIV/AIDS crosses all fields, including mental health, addictions, community development, and health care. With their expertise in providing psychological and environmental support as well as their case management skills in establishing service linkages and engaging in client advocacy, social workers have been at the forefront of efforts to improve the lives of people infected and affected by HIV disease. Social work practice in this area provides an opportunity to support young Black LGBTQ+ individuals in partnership with the H&BC. Using the Health Equity Implementation framework and the Community-Partnered Participatory Research (CPPR) involving partnership between an academic institution (UCLA CHIPTS) and a community partner (the AMAAD Institute), the proposed study will facilitate the involvement of a locally trusted social work provider agency and a community health center to develop and evaluate the effectiveness of non-medicalized social work and community engagement strategies . The proposed study will proceed in 3 phases over 2 years. The Specific Aims of the proposed study are: Aim 1: Examine barriers and challenges affecting the PrEP care continuum among young Black LGBTQ+ members of the House & Ball Community (H&BC); Aim 2: Formalize H&BC empowerment services that facilitate linkages to support and retention services provided at a comprehensive social work and grassroots engagement agency; and Aim 3: Pilot test equity-focused, community-engaged grassroots model approaches that can support the PrEP care continuum for young Black LGBTQ+ members of the H&BC.