Developing A Shared Decision Support Tool For Black And Latino Men And Their Providers To Increase Prep Uptake And Adherence

About This Grant

The proposed research study seeks to address the disproportionately high rates of HIV among young adult Black and Hispanic/Latino men who engage with men (YBLMM) in the United States by increasing pre-exposure prophylaxis (PrEP) uptake and adherence among this population. Despite the effectiveness of PrEP in preventing HIV, its uptake and adherence among this population remains suboptimal due to various barriers, including inequitable patient-provider power dynamics. Researchers have recommended the development of PrEP decision aids (PDAs) to facilitate shared decision-making between patients and their providers; however, none have been developed for YBLMM-provider dyads. Dr. Laughney's research aims to develop, implement, and evaluate a tailored PrEP decision aid (PDA) for YBLMM and their providers to increase the uptake of PrEP among this population. The study is designed with three primary aims: 1) Identify key factors that affect decisions about the uptake of PrEP modalities among YBLMM by conducting in-depth interviews with YBLMM (n=20) and their providers (n=10) to generate novel PrEP PDA content that will be used to develop an “alpha” prototype of the PrEP PDA; 2) Design an “alpha” prototype of a web-based PrEP PDA using the key factors identified in Aim 1 and develop the “beta” version of the PDA through iterative feedback from YBLMM (n=10) and providers (n=10) using in-depth interviews; 3) Evaluate the feasibility, acceptability, and appropriateness of the beta PrEP PDA among YBLMM (n=40) and providers (n=10) in a one-arm pilot trial using mixed methods to evaluate the PDA tool use in clinical settings across 6 months. YBLMM and provider dyads will be created, with one provider being paired with four YBLMM participants, resulting in 40 dyads. These preliminary data will inform the development of an R series grant that will evaluate the effectiveness of the PDA at increasing PrEP uptake and adherence among YBLMM. This proposal includes comprehensive training goals to support Dr. Laughney's development as an independent researcher specializing in HIV prevention among YBLMM. Training goals include: 1) Advance knowledge of and develop expertise in shared decision-making in minority men’s health; 2) Obtain and apply training in mixed methods for HIV prevention, specifically to inform the design of a PrEP PDA; 3) Learn how to design and develop a web-based PrEP patient decision aid tailored for YBLMM and their providers; and 4) Learn how to design, pilot, evaluate, and refine behavioral interventions that use HIV prevention decision-making tools. Dr. Laughney will collaborate with a multidisciplinary mentorship team to guide hands-on research, readings, professional development, and coursework to support the candidate’s research aims and training goals.