JMIR Publications

ABSTRACT

Background:

HIV pre-exposure chemoprophylaxis (PrEP) is recommended for populations at high ongoing risk for infection.There are noted racial disparities in the incidence of HIV and other sexually transmitted infections (STIs) for African, Caribbean, and Canadian Black (Black) populations in Ontario. Although Blacks represent only 4.7% of the Ontario population, they account for 30% of HIV prevalence and 25% of new infections in the province. The existing clinical public health practice toolkit has not been sufficient to optimize PrEP uptake,despite the overwhelming evidence of PrEP’s efficacy for reducing HIV transmission risk. Since its establishment as an effective HIV prevention tool, the major focus in behavioral research on PrEP has been on understanding and improving adherence . To date there is no known formalized intervention in place designed to support ACB men and women at high-risk to make high quality decisions regarding the adoption of PrEP as an HIV prevention practice.

Objective:

We propose two aims to address these gaps in HIV prevention and implementation science. 1. Adapt the Ottawa Decision Support Framework for use in the PrEP decisional needs of Black patients. 2. Pilot test the decision-support intervention using a two-arm randomized design to estimate effect size compared to control condition in reducing decision-conflict and predicting adherence over 60-days.

Methods:

Aim 1: We propose a cross-sectional qualitative descriptive study using data collected from key informant interviews with PrEP eligible patients (n=30) and surveys with health professionals (n=20) involved in HIV PrEP management. AIM 2. PILOT TEST THE ADAPTED DECISION-SUPPORT INTERVENTION USING A TWO-ARM RANDOMIZED CONTROLLED DESIGN. Hypothesis testing will be de-emphasized in favor of generating effect size estimates. This aim will investigate three research questions:

Results:

STUDY IS ONGOING

Conclusions:

STUDY IS ONGOING