Issues: Black college women face significant barriers in accessing comprehensive sexual health education and HIV prevention resources due to stigma, misinformation, and systemic inequities. Traditional top-down approaches often fail to engage students in meaningful discussions about safer sex practices, HIV risk reduction, and preventive care. Peer-led, relevant interventions are necessary to create comfortable spaces for dialogue and empowerment.

Description: As Risk to Reasons Curators within the Black Girls Spring for R&R (BGSR) program, we implemented Campus Kickbacks, a series of peer-led events designed to meet Black college women where they are, physically and culturally. Reaching over 38 Institutions, these kickbacks have reimagined sexual health education and ignited agency in hundreds of students across 17 states. Each curator had full autonomy to design and execute their event based on what they believed would best resonate with their campus community. This freedom led to creative initiatives, including game-based learning at “The Condom Olympics”, film screenings, panel discussions on HIV prevention, and classroom takeovers featuring advocates with lived experience. Kickbacks included STI testing, condom demonstrations, and student-led discussions, ensuring that students left with knowledge and practical tools for prevention and care.

This by Black women, for Black women approach built inclusive spaces where students discussed sexual health without fear or stigma. The Campus Kickback model has empowered young Black women to take control of their sexual health by combining education, community partnership, and peer engagement. This has set a precedent for how student-led initiatives can drive public health impact in historically underserved communities.

Lessons Learned:

Peer-led interventions increase engagement and trust in sexual health discussions. Interactive activities, storytelling, and community partnerships enhance retention and encourage open dialogue. Hosting events in student-centered spaces improves accessibility and participation. However, sustaining institutional support and ensuring ongoing access to prevention resources remain challenges.

Recommendations:

Scaling the Campus Kickback model through university partnerships, student organizations, and public health agencies can enhance HIV prevention efforts across Historically Black Colleges and Universities and beyond. Future initiatives should integrate digital engagement strategies, expand community partnerships, and advocate for consistent funding to ensure continued access to sexual health education and preventive resources.

Introduction: Chemsex is a risky sexual behavior where drugs are used to enhance and extend sexual pleasures. Chemsex drug use is a risk factor for HIV, especially among men who have sex with men (MSM), and HIV Pre-Exposure Prophylaxis (PrEP) is often indicated for preventing HIV. This study aims to examine the association between chemsex drug and PrEP use among MSM living in Georgia, a southern U.S. state.

Methods: Data were collected from adult HIV-negative MSM (≥18 years) and living in Georgia between June and December 2020 (N=168). If the respondents reported using methamphetamine, poppers, ecstasy, or Viagra, within the last 30 days, they were categorized as using chemsex drugs (yes/no).PrEP use derived from the question “The last time you had sex, were you taking Pre-Exposure Prophylaxis (PrEP, like Truvada®)? Other covariates include age (18-25, 25-35, 36-50, ≥50), race (Black, White, other), education (≤high school, some college, bachelor, higher), residence (urban, rural), homelessness (no, yes), met with partner (online/app, in-person), and number of partners in last sex (1, ≥2). Descriptive, bivariate, and multivariable analyses were performed using Stata 18.5.

Results: More than one-third (36.9%) of the respondents reported using PrEP after last time they had sex. The majority of the respondents were White (55.4%), lived in urban areas (71.4%), housed (82.1%), met with a partner online/App (75.0%), and had one partner in the last sex (85.7%). In the multivariable logistic regression analysis, the likelihood of PrEP use was higher among those who used chemsex drug [adjusted Odds Ratio (aOR): 4.52, p<0.001], White (aOR: 6.67, p=0.001), and Other (aOR:7.69, p=0.003) than Black.

Conclusion: The findings highlight that while the MSM who use chemsex drugs are more likely to use PrEP, racial disparities in PrEP uptake persist. Targeted intervention is required to improve PrEP access among Black MSM in Georgia.

Background: Pre-exposure Prophylaxis (PrEP) is an effective intervention for reducing HIV transmission. However, its success depends on various factors including, but not limited to, availability and PrEP navigation services. This programmatic evaluation examines the barriers and facilitators for the PrEP referral process implemented by a HIV prevention team in Detroit emergency departments (EDs) to identify areas for improvement.

Methods: HIV testers and counselors within the Department of Emergency Medicine at Wayne State University, School of Medicine were recruited to participate in a 1-hour focus group led by a trained facilitator. The focus group was audio recorded and transcribed. All participants were asked to complete a basic demographic survey electronically prior to the start of the focus group. A grid qualitative data analysis approach was used to identify themes and key talking points.

Results: Of the 8 participants, 4 (50.0%) reported their current gender identity as female, 5 (62.5%) reported as White, 6 (75.0%) were between the ages of 18-25 years old, and 6 (75.0%) have greater than one years of experience. Participants indicated key barriers to giving referrals, including time constraints, the fast-paced nature of the ED, and patient misconceptions about PrEP. Privacy concerns and familial influence further hindered referrals. Facilitators included personal experience with PrEP, prior patient knowledge and access to educational resources.

Conclusion: These findings highlight the need for targeted interventions (e.g., additional staff training, time management strategies, or client privacy solutions) to improve PrEP referral rates in our ED settings for the staff. The HIV Testers and Counselors will also be completing data collection regarding why individuals are refusing PrEP referrals, as a result of the focus group, so that patient-centric interventions can be implemented as well.

Background: The HIV/AIDS epidemic remains a critical public health concern in Zambia, especially among young adults aged 15 to 24 years, who account for a significant portion of new infections. Pre-Exposure Prophylaxis (PrEP) has been identified as a potent biomedical strategy to prevent HIV acquisition in high-risk groups. This study examines the awareness, willingness, and determinants influencing PrEP utilization among Zambian young adults within this age bracket. The global HIV response has moved closer to the goal of ending AIDS as a public health threat by 2030, a commitment enshrined in the sustainable development goals. More effort and urgency is required to accelerate prevention and breakdown the barriers that keep marginalized people from both prevention and treatment services.

Methods: Employing a cross-sectional design, the study analyzed data from the Zambia Population-Based HIV Impact Assessment (ZAMPHIA), a nationally representative survey conducted to assess the country's HIV epidemic and inform public health initiatives. The survey encompassed a diverse sample of respondents from various regions across Zambia, providing a comprehensive overview of PrEP-related perceptions among young adults.

Findings: The analysis revealed a moderate level of PrEP awareness among participants; however, actual uptake was notably low. Primary barriers identified included limited access to PrEP services, apprehensions regarding potential side effects, and societal stigma associated with its usage. Conversely, factors such as a heightened perceived risk of HIV infection and recommendations from healthcare providers were positively correlated with a willingness to use PrEP.

Implications: These findings highlight the urgent need for targeted educational campaigns aimed at enhancing PrEP literacy among Zambian youth. Integrating youth-friendly services within existing healthcare frameworks could improve accessibility and address concerns related to PrEP usage. Furthermore, implementing community engagement strategies to reduce stigma is essential for fostering a supportive environment that encourages PrEP adoption.

Addressing these factors is pivotal for optimizing PrEP uptake and, consequently, reducing HIV incidence among young adults in Zambia. This study underscores the importance of comprehensive, culturally sensitive interventions that consider the unique challenges faced by this demographic in the fight against HIV/AIDS.

Objective: Examine utility of motivational interviewing focused interventions across the PrEP care continuum.

Background: Pre-exposure prophylaxis (PrEP) is effective in reducing HIV risk, but remains underutilized among people who could benefit from it. Motivational interviewing (MI) demonstrates potential for improving PrEP care continuum participation. Despite this, there is a dearth of literature exploring MI utility across the totality of the PrEP continuum.

Methods: A systematic review was conducted to examine the impact of interventions employing MI on PrEP care continuum. Peer-reviewed studies were included if published between 2013 – 2024 and explored PrEP continuum interventions using MI. The review was guided by Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) prescriptions. Study quality was evaluated by LEGEND (Let Evidence Guide Every New Decision) guidelines. Covidence software facilitated analysis.

Results: There were 685 studies identified and 27 were included in the review. The majority of studies were executed in the United States though nine occurred in Sub-Saharan Africa. Using LEGEND guidelines, the majority of studies (n=25) were deemed acceptable quality. A plurality of studies focused on adherence exclusively (n=10) and 19% examined multiple aspects of the PrEP continuum. Feasibility and acceptability for interventions employing MI was generally high. Well-designed studies generally demonstrated effectiveness of interventions with MI components for increasing PrEP care continuum participation. MI was often used to augment existing interventions. Facilitators of useful MI interventions include capable staff, fidelity monitoring, and intervention tailoring.

Conclusions: Though the research on MI and PrEP is relatively nascent, MI demonstrates utility in advancing PrEP care continuum participation. More research should be conducted

Issues:
Emergency departments (EDs) serve as critical access points for HIV and hepatitis C (HCV) screening, yet most EDs continue to rely on risk-based testing, which can lead to missed diagnoses and disparities in care. The CDC and USPSTF recommend routine, opt-out screening, but widespread implementation faces challenges, including workflow integration, provider training, and ensuring effective linkage to care. Understanding provider perspectives and barriers is essential for designing successful screening programs.

Description:
To inform the transition to opt-out HIV and HCV screening in our academic ED, we conducted a knowledge, attitudes, and practices (KAP) survey of emergency medicine physicians and advanced practice providers (APPs). While a majority of respondents recognize the importance of routine HIV screening in the ED, fewer feel the same about HCV screening. Most providers agree that the ED is a key public health access point, yet testing remains infrequent. The top barriers to routine screening include concerns about linkage to care (cited by 78%), lack of provider education (63%), and absence of a clear hospital policy (58%). Additional challenges include fear of false positives, patient refusal, time constraints, and stigma. Notably, less than half of providers feel very comfortable delivering a positive HIV or HCV result to a patient, emphasizing a need for further training.

Lessons Learned:
Our findings highlight critical gaps in provider confidence and knowledge that may hinder the adoption of opt-out screening. Stronger linkage-to-care pathways, standardized screening policies, and enhanced provider education are essential to increasing provider engagement and ensuring successful program implementation.

Recommendations:
To support a smooth transition to opt-out screening, we recommend: (1) strengthening linkage-to-care processes to improve follow-up and minimize provider concerns, (2) developing a standardized hospital policy to ensure consistent screening practices, and (3) implementing targeted provider education on screening protocols, result counseling, and patient-centered communication. These strategies will be integrated into our implementation plan, with future evaluations focusing on their impact on screening rates and provider engagement.

Issues

Black women, though representing only 7% of the U.S. population, account for nearly 70% of new HIV diagnoses among women in the South. Historically, Black women have been sidelined in HIV efforts, making community-driven, culturally responsive interventions essential. Strategies such as peer-led education, increased access to PrEP and HIV/STI testing, and trauma-informed care are vital to addressing these disparities. Strengthening partnerships between HBCUs, public health organizations, and Black-led advocacy groups can expand resources and funding for prevention.

Description:

Black Girls Spring for R&R is a community-driven initiative tackling HIV disparities. From 2023 to 2025, 25 campus ambassadors were recruited to build programs that promote HIV awareness, reduce stigma, and strengthen advocacy. An immersive Alternative Spring Break Weekend (ASBW), brought together ambassadors on HBCU campuses to share in workshops on person-first language, reframing HIV risk to focus on reasons for health and HIV prevention and care. Peer mentors modeled leadership and provided social and technical support to empower ambassadors to transition from awareness to advocacy to activism.

Lessons Learned:

Diverse HBCU cultures across institutions benefitted from the campus specific initiatives developed to transform educational spaces into hubs of empowerment and activism. Peer-led efforts were crucial in reducing stigma and cultivating future public health leaders.

Recommendations:

Securing funding for peer-led, equity-centered initiatives is critical. Strengthening partnerships with under-resourced HBCUs, fostering leadership development, and integrating experiential learning will enhance culturally responsive programs. Expanding advocacy through policy engagement and media will ensure Black women’s HIV prevention needs remain prioritized.

Background: Effectively reaching and identifying high priority populations remains a significant challenge in HIV prevention. The optimal application of molecular epidemiology remains unclear. This study explored how molecular and space time cluster information can complement traditional surveillance methods in identifying and reaching high-risk individuals, reducing new infections, and advancing efforts to end the HIV epidemic.

Methods: A narrative review was conducted using PubMed, focusing on studies related to molecular testing, genetic testing, transmission clusters and networks, and space-time clustering in the context of HIV/AIDS surveillance published between 2019 and 2024.

Results: Twenty-six peer reviewed articles were analyzed, revealing four key themes emerged: (1) Multidisciplinary approaches: Combining molecular data with traditional methods improved identification of social and behavioral patterns in transmission networks - patterns that molecular epidemiology alone might have missed - and informed more targeted interventions; (2) Hotspot identification through space-time clustering: Integrating spatial clustering with molecular data and traditional surveillance demonstrated that geographic factors play a critical role in shaping cluster formation, revealing specific locations with high transmission rates; (3) Predictive utility of simulation models: Simulation models were effective in predicting transmission clusters and detecting gaps in HIV surveillance by identifying undiagnosed infections within transmission networks; and (4) Prioritizing high-risk populations: Molecular clustering methods identified high-priority groups frequently that were frequently found in active clusters.

Conclusion: Integrating molecular epidemiology, space-time clustering, and traditional surveillance methods improves HIV prevention by identifying high-risk populations and informing development of targeted interventions. Additionally, simulation models demonstrated predictive capabilities in transmission networks, pinpointing areas for intervention opportunities. This combined approach strengthens efforts to reach high-risk groups and direct focused interventions, further advancing efforts to end the HIV epidemic.

Introduction: Despite PrEP's effectiveness in preventing HIV, uptake among young men who have sex with men (YMSM) remains low. Factors like intimate partner violence (IPV) and sexual coercion can hinder PrEP engagement, increasing HIV vulnerability. However, limited research has examined how distinct relationship experiences impact PrEP knowledge, uptake, and self-efficacy.

Methods: This study used data from the #MVMNT project, a longitudinal study (2019–2024) examining social and geographical influences on HIV risk among YMSM (n = 401) aged 18–34. Latent Profile Analysis (LPA) was conducted using indicators related to dating app use, number of sexual partners, concurrent sexual partnerships, sexting behaviors, and IPV.

Results: Two relationship experience groups emerged: Group 1 (83.3%, n = 303), characterized by lower app use (M = 2.98, SD = 0.50), less frequent casual sexual behavior (M = 3.89, SD = 1.24), and Group 2 (16.7%, n = 60), characterized by higher app use (M = 3.91, SD = 0.81), and more frequent casual sexual behavior (M = 1.13, SD = 0.92). Binary logistic regression models adjusting for age, ethnicity, marital status, income, insurance status, employment, and home ownership showed Group 2 had higher odds of PrEP awareness (OR = 5.86, 95% CI: 0.99, 34.78) and uptake (OR = 2.18, 95% CI: 1.09, 4.37) compared to Group 1.

Conclusions: Results suggest that YMSM who engage more frequently in casual sexual behavior, app use, and sexting may be more aware of PrEP and likely to uptake, potentially due to increased exposure to HIV prevention messaging and higher perceived risk.

HIV and the social context have been the cornerstone of Black women’s HIV experience since HIV was named in 1981; nearly 45 years later, this remains true. Black women (BW) comprise less than 15% of the female population in the U.S., yet account for nearly 60% of new HIV cases among women. The integration and centering of BW in ending the HIV epidemic continue to be a step behind. We launched I AM HIV Possible (IAHP) focusing on PrEP awareness and corresponding uptake, stigma reduction, and education by partnering with five digital influencers with different backgrounds and expertise.

IAHP celebrated storytelling and speaking truth to power as core values of the Black experience, underscoring Black beauty, brilliance, and bravery in its messaging. Coupling this approach with the lived experiences of BW on PrEP resulted in 1.2 million views of IAHP content on social media. The average engagement rate was 3x the rate of healthcare content on Instagram in 14-months. IAHP had a booth at Essence Fest 2024 and Women Evolve 2024 to 1) reflect on the stories and sexual health tools that align with BW’s lived experiences, 2) promote PrEP awareness among BW, and 3) field a survey to better understand BW’s HIV prevention needs.

Of the 924 BW surveyed, 4% (n=33) identified as BW of trans experience and 96% (n=891) as cisgender. Nearly 60% (n=538) were between the ages of 20 and 44, and 77% (n=452) of all BW reported being aware of ways to prevent HIV. However, 61% (n=567) of all respondents reported being aware of PrEP, and 27% (n=245) reported PrEP awareness as an HIV prevention option for BW. Of the 87 BW who did not believe that PrEP is a good HIV prevention option, 77% (n=68) were either unaware of PrEP or unaware that it is an option for HIV prevention for BW.

BW expressed a desire to learn from and engage with BW on PrEP such as IAHP’s influencers. Our survey results highlight the continued challenges around HIV prevention efforts among BW, centering BW’s real-time information needs despite BW’s vulnerability to HIV.