T’Cher, Take Charge: A Increasing PrEP Awareness, Uptake, and Adherence Through Health Care Empowerment and Addressing Social Drivers of Health in the Deep South

Public Health Foundation Enterprises, City Of Industry CA

Investigators

Abstract

New cases of HIV epidemic continue to rise in the Deep South. Among states in the Deep South that report most new HIV infections, HIV diagnosis rates in Louisiana were second only to Georgia. Our team conducted the first population- base HIV surveillance study of key high-risk populations in southeastern Louisiana and 46% tested positive for HIV. These findings are consistent with the most recent Louisiana Department of Health (LDH) STD/HIV annual report in 2018 that identified high risk groups as bearing the largest burden of HIV in Louisiana. Despite the impact of HIV on high-risk groups in New Orleans, no evidence-based PrEP interventions or efforts are underway to meet community needs. Our team proposes to test the T’Cher Take Charge: Increasing PrEP Awareness, Uptake, and Adherence Through Health Care Empowerment and Addressing Social Behavioral Drivers of Health Barriers in the Deep South intervention. The intervention will include a social media campaign to increase PrEP awareness. It will also include peer navigation to build trust and provide PrEP navigation. We will tailor the peer navigation model from a prior study to be implemented digitally and enhanced using mHealth methods. Namely, we will also use motivational interviewing and ecological momentary assessments to increase health care empowerment and address social behavioral drivers that create barriers to PrEP uptake and adherence. We will recruit 200 participants in our study using methods proven successful in our prior HIV research. Participants will be engaged in the intervention for 12 months, providing enough time to address barriers to PrEP and support adherence. The goals of this proposed T'Cher, Take Charge intervention are: (1) To develop, implement and measure the impact of a T'Cher, Take Charge social media campaign on PrEP awareness among participants in LA using a population-based sample; (2) To test the impact of the T'Cher, Take Charge digital mHealth peer navigation model on increasing PrEP uptake and adherence among participants in LA, using a randomized stepped wedge cross-over study design; and, (3) To assess changes in health care empowerment and support for social behavioral drivers as mediating factors in PrEP uptake and adherence. Our goal is to used lessons learned to adapt existing HIV prevention interventions to meet the needs of high-risk groups in Louisiana. With evidence of effectiveness, we are prepared to test the intervention at scale throughout the Deep South to strengthen PrEP access and utilization in the Deep South.