The purpose of this multi-method implementation science study called Justice-PrEP (J-PrEP) is to examine the current HIV Pre-exposure prophylaxis (PrEP) care landscape and identify opportunities for PrEP scale-out in jail settings for HIV-uninfected Black men who have sex with men (BMSM) who are impacted by dual epidemics of HIV and incarceration. We will utilize the Exploration phase of the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework as a guide to inform data collection, analysis, and interpretation. We seek to identify gaps and opportunities to deliver conventional PrEP (i.e., oral PrEP daily dosing based on current CDC guidelines) and non-conventional PrEP (e.g., on-demand, same day start, directly observed therapy) forms of PrEP in jails and prior to release for jail-involved BMSM. The study will be conducted in two diverse contexts with high HIV rates (i.e., Chicago and Baton Rouge). It will be led by a team of investigators at the University of Chicago in collaboration with community partners and a Scientific Advisory Group.
Aim 1 : Determine awareness, acceptability, and early adoption of conventional and non- conventional forms of PrEP among jail-involved HIV-uninfected BMSM using the Exploration phase of the EPIS framework. To accomplish this aim, we will: (1) leverage an existing cohort of HIV-uninfected BMSM (N=450) by adding jail specific items to the survey in order to determine estimates for awareness, acceptability, and early adoption of conventional and non-conventional forms of PrEP in jail context; and (2) conduct in-depth interviews with N=60 jail-involved HIV- uninfected BMSM (n=30 in each city) to provide rich contextual data.
Aim 2 : Examine awareness, acceptability, appropriateness, and feasibility of implementing conventional and non-conventional forms of PrEP within jail settings from the perspective of justice-involved stakeholders using the Exploration phase of the EPIS framework. To accomplish this Aim, we will conduct in-depth interviews with 30 justice-involved stakeholders (n=15 in each city) to assess: a) their awareness and perceptions about conventional and non- conventional forms of PrEP delivery; b) potential fit within their agency; c) how PrEP is currently implemented or how the various forms of PrEP could be implemented; and d) the resources (e.g., staff, training, cost) required to implement the various forms of PrEP in jail and prior to release. Study findings will be used to inform the development of a future multi-city study advancing the Preparation and Implementation phases of the EPIS framework as we scale-out PrEP implementation in jail settings for HIV-uninfected BMSM.
The Justice-PrEP (J-PrEP) study examines the current HIV Pre-exposure prophylaxis (PrEP) care landscape and opportunities for PrEP scale-out in jails and prior to release for HIV- uninfected Black men who have sex with men (BMSM).
