A Multicomponent Strategy to Improve HIV Pre-Exposure Prophylaxis in a Southern US Jail: Protocol for a Type 3 Hybrid...

Area of Science:

• Public Health
• Implementation Science
• HIV Prevention

Background:

• Pre-exposure prophylaxis (PrEP) is underutilized by key populations, including those in the Southern US and involved in the criminal legal system.
• Improving PrEP access for these groups can reduce HIV health disparities and impact public health due to high jail-community turnover.
• HIV prevention for criminal legal-involved individuals has significant public health implications.

Purpose of the Study:

• To develop, implement, and evaluate a multicomponent PrEP strategy at the Dallas County Jail (DCJ).
• To increase the initiation of pre-exposure prophylaxis (PrEP) among criminal legal-involved individuals.
• To reduce HIV incidence in a high-risk population.

Main Methods:

• A type 3 hybrid implementation-effectiveness study using the EPIS framework.
• Qualitative interviews to identify barriers and facilitators to PrEP linkage.
• Development of an EHR-based HIV risk prediction model and integration of a PrEP patient navigator.

Main Results:

• Qualitative findings from 26 interviews have informed the PrEP implementation strategy.
• An HIV risk prediction model using EHR data has been developed and validated.
• Preliminary findings are anticipated in 2026.

Conclusions:

• The study will yield insights into the feasibility and effectiveness of a jail-based PrEP strategy.
• This scalable strategy can serve as a model for other urban jails to address HIV inequities.
• The findings will support efforts to increase PrEP uptake among justice-involved populations.