JMIR Publications

ABSTRACT

Background:

African American or Black young men who have sex with men (BYMSM) are at a disproportionate risk for contracting HIV and hold higher rates of undiagnosed and therefore untreated HIV infection. In the southern United States, BYMSM face additional hurdles (e.g., access to care, structural racism, intersectional stigma, etc.) to HIV testing and prevention, necessitating interventions to address sociocultural and structural barriers while motivating BYMSM to test and consider pre-exposure prophylaxis (PrEP). Brothers Saving Brothers (BSB) is a Motivational Interviewing behavioral intervention that successfully and simultaneously increased community-based HIV testing and prevention education among BYMSM in the midwestern United States.

Objective:

The aim of this protocol is to detail the adaption process of the BSB intervention for midwestern BYMSM to the Kings intervention for southern BYMSM. During the adaptation process, the intervention will be modernized to include rapid HIV testing as compared to HIV testing that required BYMSM to return for test results, PrEP, provision of structural supports, and for relevance in the southern United States. Through the adaptation, this protocol integrates implementation science and effectiveness research to minimize the science-practitioner gap, leading to improved scale-up and dissemination.

Methods:

Intervention adaptation will be informed by two specific aims. Aim 1 is to gather qualitative data through focus groups and in-depth interviews with BYMSM aged 18-29 years in Alabama, in-depth interviews with prevention and outreach workers who routinely work with young African American or Black sexual and gender minorities, including both BYMSM and African American or Black transgender women, and in-depth interviews with African American or Black transgender women. NVivo qualitative software will be used for coding and analysis of the transcripts in a thematic analysis approach. In Aim 2, the adaptation process will be guided by intervention mapping. Intervention mapping will inform the adaptation process, and intervention content, components, and design. Both Aims 1 and 2 will leverage the Exploration Preparation Implementation Sustainment (EPIS), process implementation science framework, with emphasis on the exploration and preparation phases. Applying these frameworks, the original midwestern BSB intervention will be rigorously adapted to become the southern Kings intervention.

Results:

This study is ongoing and is expected to conclude in 2024. Qualitative data will offer insight into the current real-world experiences and preferences of the populations we aim to serve. Feedback will be collected through the intervention process for refinement. Institutional review board approvals have been received.

Conclusions:

Findings will inform next steps, specifically testing the Kings intervention for feasibility, acceptability, and preliminary effectiveness in a pilot hybrid type 1 effective-implementation randomized controlled trial. Study results will provide insights about important considerations for HIV prevention among BYMSM in the southern United States. Clinical Trial: ClinicalTrials.gov NCT03680729