Addressing disparities in Pre-exposure Prophylaxis (PrEP) access: implementing a community-centered mobile PrEP...

Area of Science:

• Public Health
• HIV Prevention
• Health Equity

Background:

• Pre-exposure prophylaxis (PrEP) is crucial for HIV prevention but faces access disparities, especially among Black and Latino men who have sex with men (MSM).
• The University of Miami Mobile PrEP Program was established to provide HIV prevention services in underserved areas with limited access.
• A community-centered approach guided the program's expansion into Miami's Liberty City neighborhood.

Purpose of the Study:

• To qualitatively assess factors influencing the implementation of a mobile HIV prevention program.
• To understand community stakeholder, client, and staff perceptions of barriers and facilitators to mobile PrEP services.

Main Methods:

• Conducted 41 in-depth interviews with clients, key informants, and program staff.
• Explored perceived barriers, facilitators, service satisfaction, and likelihood of recommendation.
• Utilized thematic content analysis guided by the Consolidated Framework for Implementation Research (CFIR).

Main Results:

• Facilitators included no-cost services, convenient locations, transportation support, patient navigation, and culturally competent staff.
• Community engagement and familiarization were vital, particularly for Black and African American communities facing unique healthcare barriers.
• A community-centric approach fostered trust and improved intervention uptake.

Conclusions:

• The Mobile PrEP intervention is an acceptable and accessible method for HIV/STI preventive care.
• Pre-implementation community engagement and preparation are critical for successful program rollout.
• Further research is needed to optimize intervention components and evaluate implementation in diverse, high-impact areas.