Community engagement and linkage to care efforts by peer community‐health workers to increase PrEP uptake among sexual minority men

Farley, Jason E.; Dangerfield, Derek T.; LaRicci, Jessica; Sacamano, Paul; Heidari, Omeid; Lowensen, Kelly; Jennings, Jacky M.; Tobin, Karin E.

doi:10.1111/phn.12887

Cited by 17 publications

(22 citation statements)

References 27 publications

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“…A growing body of literature has also demonstrated the effectiveness of peer CHWs in helping to increase access to needed HIV and other prevention and intervention services, while minimizing stigma (47,48). The use of peer community health agents has also been linked to a decrease in the level of stigma in typical healthcare-related interactions that can interfere with addressing HIV and other STIs, HCV and concomitant risks of substance use disorder and intimate partner violence (49).…”

Section: Interventionmentioning

confidence: 99%

Trauma, Mental Health Distress, and Infectious Disease Prevention Among Women Recently Released From Incarceration

et al. 2022

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BackgroundU.S. women recently released from incarceration experience significantly higher rates of trauma and exacerbation of mental health conditions, and the period following release has been identified as a window of heightened risk for mental health distress and human immunodeficiency virus (HIV), sexually transmitted infections (STI) and hepatitis C (HCV) transmissions. Despite these vulnerabilities, and an urgent need for supports, optimal engagement strategies remain unclear. WORTH Transitions is a program made up of two evidence-based interventions focused on improving the health of women returning to the community from incarceration with substance use disorders. Combining the two was designed to reduce HIV/STIs/HCV risks and increase overall health treatment engagement using a community health worker led intervention.MethodsWe examined associations between trauma, mental health symptomology, and HIV/STI/HCV outcomes among women who engaged in the WORTH Transitions intervention (N = 206) Specifically, bivariate and longitudinal multivariate models were created to examine associations between trauma and mental health distress (defined as depressive and PTSD symptoms), on (1) types of engagement in HIV/STIs/HCV prevention and behavioral health services; and (2) HIV/STIs/HCV risk outcomes. The women who engaged in the intervention were 18 years and older and some were White, Black and other racial or ethnic minority.ResultsPTSD symptomology and being a Black or indigenous woman of color was significantly (p = 0.014) associated with individual or group session engagement. Neither trauma nor PTSD symptoms were associated with higher HIV/STIs/HCV risks. Instead, relative to those who did not engage in HIV/STI/HCV risky behaviors, PTSD symptomology (p = 0.040) was associated with more than 3-fold increase in the probability of being lost to follow up (relative risk ratio = 3.722).ConclusionGiven the impact of PTSD-related symptoms on driving both engagement in HIV/STIs/HCV prevention services and intervention attrition among women leaving incarceration, physical and behavioral health interventions must be both overtly trauma- and mental health-informed. As was the case with WORTH Transitions, physical and behavioral health services for this population must include intentional and active support of the forms of treatment participants endorse to ensure maximal engagement.

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Section: Interventionmentioning

confidence: 99%

Trauma, Mental Health Distress, and Infectious Disease Prevention Among Women Recently Released From Incarceration

et al. 2022

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“… 3 Community health workers have been trained to conduct PrEP outreach and provide referrals to PrEP prescription services. 4 There are also mobile applications that offer PrEP prescriptions from a qualified health worker but without an in-person visit. 5 Making PrEP available outside of formal health facilities has the potential to reduce barriers to access, improve autonomy and increase use and coverage of these effective HIV prevention options.…”

Section: Introductionmentioning

confidence: 99%

PrEP distribution in pharmacies: a systematic review

et al. 2022

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IntroductionNovel mechanisms of service delivery are needed to expand access to pre-exposure prophylaxis (PrEP) for HIV prevention. Providing PrEP directly through pharmacies could offer an additional option for reaching potential users.MethodsWe conducted a systematic review of studies examining effectiveness, values and preferences of end users and health workers, and cost of PrEP initiation and continuation through pharmacies (pharmacy access). We searched PubMed, CINAHL, LILACS and EMBASE through 2 December 2020. We also searched clinical trial registries and recent HIV conference abstracts. Standardised methods were used to search, screen and extract data from included studies.ResultsNo studies met the inclusion criteria for the effectiveness review, for either PrEP initiation or continuation. However, six ‘case studies’ presenting non-comparative data from PrEP pharmacy programmes demonstrated feasibility of this model in the USA. Eleven studies reported values and preferences of end users and health workers. In the USA, Kenya and South Africa, potential PrEP clients generally supported pharmacy access, although some preferred clinics. One study of PrEP pharmacy clients found all would ‘definitely recommend’ the programme. Six studies found pharmacists were generally supportive of offering PrEP; one study including doctors found more limited favour, while one study of diverse Kenyan stakeholders found broad support. Three studies reported cost data indicating client willingness to pay in the USA and Kenya and initial sustainability of a clinic financial model in the USA.ConclusionProvision of PrEP through pharmacies has been demonstrated to be feasible in the USA and acceptable to potential end users and stakeholders in multiple settings. Limited evidence on effectiveness and requirements for laboratory testing and assurance of high-quality services may limit enthusiasm for this approach. Further research is needed to determine if pharmacy access is a safe and effective way to help achieve global HIV prevention goals.PROSPERO registration numberCRD42021231650.

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Section: Introductionmentioning

confidence: 99%

“…We designed a multicomponent intervention that consists of an existing smartphone app called PrEPme [ 18 ] and a PCA to increase perceived HIV risk and willingness to initiate PrEP among BSMM. Briefly, PrEPme is a smartphone app designed for Maryland users to obtain statewide PrEP service information and navigation support from a community health worker [ 18 ]. PrEPme also allows users to self-monitor sexual risk behaviors, view a graph of sexual risk behaviors by week and month ( Figure 1 ), and chat with the in-app community health worker to obtain PrEP service information [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

“…Briefly, PrEPme is a smartphone app designed for Maryland users to obtain statewide PrEP service information and navigation support from a community health worker [ 18 ]. PrEPme also allows users to self-monitor sexual risk behaviors, view a graph of sexual risk behaviors by week and month ( Figure 1 ), and chat with the in-app community health worker to obtain PrEP service information [ 18 ]. In our intervention, we planned for a PCA to meet with HIV-negative BSMM during 2 sessions one month apart.…”

Section: Introductionmentioning

confidence: 99%

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Refining a Multicomponent Intervention to Increase Perceived HIV Risk and PrEP Initiation: Focus Group Study Among Black Sexual Minority Men

Dangerfield¹,

Anderson²,

Wylie³

et al. 2022

JMIR Form Res

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Background Increased preexposure prophylaxis (PrEP) initiation is needed to substantially decrease HIV incidence among Black sexual minority men (BSMM). However, BSMM perceive others as PrEP candidates instead of themselves and are less likely than other groups to use PrEP if prescribed. Peers and smartphone apps are popular HIV prevention intervention tools typically used independently. However, they could be useful together in a multicomponent strategy to improve perceived HIV risk and PrEP initiation for this group. Information regarding attitudes and preferences toward this multicomponent strategy is limited. Objective The goal of this study is to obtain attitudes and perspectives regarding the design of a multicomponent intervention that uses a smartphone app and a peer change agent (PCA) to increase perceived HIV risk and PrEP initiation. The intervention will be refined based on thematic findings for a culturally responsive approach. Methods Data were obtained guided by life course theory and the health belief model using 12 focus groups and 1 in-depth interview among HIV-negative BSMM from Baltimore, MD, between October 2019 and May 2020 (n=39). Groups were stratified by the following ages: 18 to 24 years, 25 to 34 years, and 35 years and older. Participants were provided details regarding an existing mobile app diary to self-monitor sexual behaviors and a hypothetical PCA with whom to review the app. Facilitators posed questions regarding perceived HIV risk, attitudes toward the app, working with a PCA, and preferences for PCA characteristics and approaches. Results Most participants identified as homosexual, gay, or same gender-loving (26/38, 68%), were employed (26/38, 69%), single (25/38, 66%), and interested in self-monitoring sexual behaviors (28/38, 68%). However, themes suggested that participants had low perceived HIV risk, that self-monitoring sexual behaviors using a mobile app diary was feasible but could trigger internalized stigma, and that an acceptable PCA should be a possible self for BSMM to aspire to but they still wanted clinicians to “do their job.” Conclusions HIV-negative BSMM have dissonant attitudes regarding perceived HIV risk and the utility of a mobile app and PCA to increase perceived HIV risk and PrEP initiation. Future research will explore the feasibility, acceptability, and preliminary impact of implementing the multicomponent intervention on perceived HIV risk and PrEP initiation among BSMM in a pilot study.

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Community engagement and linkage to care efforts by peer community‐health workers to increase PrEP uptake among sexual minority men

Cited by 17 publications

References 27 publications

Trauma, Mental Health Distress, and Infectious Disease Prevention Among Women Recently Released From Incarceration

Trauma, Mental Health Distress, and Infectious Disease Prevention Among Women Recently Released From Incarceration

PrEP distribution in pharmacies: a systematic review

Refining a Multicomponent Intervention to Increase Perceived HIV Risk and PrEP Initiation: Focus Group Study Among Black Sexual Minority Men

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