Race and the public health impact potential of PrEP in the United States
Description: PrEP Chicago is an intervention that couples network level diffusion of innovation with linkage to PrEP care in community areas at high risk for ongoing HIV transmission. Early diffusion including knowledge, preparation and adoption are a major focus. Purposeful selection and training of peer change agents to drive diffusion through person to person communication and motivation leads to PrEP engagement and linkage to care.
Lessons Learned: Diffusion of innovation in community areas such as the South Side is largely word of mouth and most effective from a grassroots or bottom-up approach. While Medicaid expansion makes PrEP care more accessible, navigation of different medical homes, insurance providers and referral restrictions adds additional complications to PrEP care engagement. In contexts without Medicaid expansion, additional barriers likely exist.
Recommendations: Real-world PrEP access and utilization by those with highest HIV incidence, such as younger Black MSM, faces major implementation challenges that require purposeful and sustained engagement with racial/ethnic minority communities and navigation of a complicated health care environment.
Provision of health care to the public
Public health or related public policy
Social and behavioral sciences
Describe facilitators and barriers to PrEP engagement in urban settings Analyze emerging racial disparities in PrEP engagement
Keyword(s): HIV/AIDS, African American
Qualified on the content I am responsible for because: I have a MD and MPH, have been the principal or co-principal of multiple federally funded grants focusing on the epidemiology of HIV prevention, younger Black MSM HIV prevention and network analysis. Among my scientific interests has been the development of strategies for HIV prevention engagement.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.