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Background: The United States envisions a 90% reduction in HIV infections by 2030. However, the COVID-19 pandemic disrupted the HIV continuum and disproportionately affected access to social and health services for people at the highest vulnerability. This study shows how stakeholders in the State of Michigan handled disruptions and their key recommendations. As a case study, this study adds to the literature about preparedness for future pandemics. Methods: We interviewed 33 statewide Michigan HIV/AIDS Council members—practitioners, researchers, and community representatives, guiding service planning, improvement, and resource allocations, measuring group cohesiveness using a tested scale. We measured group cohesiveness as a proxy for how individual opinions reflected those of the Council as a group. We used qualitative questions to assess: (1) how the COVID-19 pandemic disrupted HIV prevention; (2) how disruptions were handled; and (3) recommendation to help address disruptions now and in the future. Using thematic analysis, we coded the interviews. Results: We found a high degree of cohesiveness. Participants agreed that the pandemic disrupted HIV prevention services (e.g., HIV testing, PrEP education, referrals to primary care, etcetera) offered by community organizations, hospital clinics, and health departments across the state. In response, they developed online and curbside services to maintain HIV services, abate social isolation, and address structural issues like lack of food and public transportation. We organized results in four categories: (1) HIV service disruptions (e.g., "Housing for women and children who are fleeing a legal situation"); (2) Responses to disruptions (e.g., "Some of them, we would say, hey, weather permitting, we'll come out to your car"); (3) Minoritized groups disproportionately affected (e.g., "Especially in my community, to get people if there's ever a vaccine, Black people are going to be the last people to take it"); and (4) Recommendations (below). Conclusions: The pandemic unsettled and further exacerbated every aspect of HIV service provision. The main recommendation was to overhaul communication systems between government and organizations offering HIV services to mitigate disruptions and improve the chances of achieving a 90% reduction. [ABSTRACT FROM AUTHOR]

The article focuses on the COVID-19 pandemic disrupts HIV continuum of care and prevention. Topics include the time shelter-in-place orders has accelerated, community-based organizations (CBOs) have closed, the extent to which the COVID-19 pandemic has disrupted the HIV Continuum of Care and Prevention, and the pre-exposure prophylaxis (PrEP), and primary care and propose a course of action so that we may end the HIV epidemic in this decade.

The first steps of the HIV care continuum include patients finding access to HIV testing and primary care. Psychosocial providers ("providers"), such as social workers, health educators, and outreach workers comprise a workforce tasked with linking patients to HIV testing and primary care. This study examines longitudinal associations between provider- and organization-level factors and linkage to HIV testing and primary care. The sample included 245 providers in 36 agencies in New York City. We used longitudinal data (baseline and 12- and 24-months follow-ups) and multilevel ordinal logistic regression to examine associations between factors distributed in three theoretical socioecological domains: individual (demographic and HIV training characteristics); relationship (interprofessional collaboration); and agency (size and capacity), and frequency of HIV testing and primary care linkages. Approximately 30% of providers linked 20 or more patients to HIV testing or HIV primary care in the previous six months. Providers' higher endorsement of interprofessional collaboration at 12 months, formal HIV training, younger age, and Latinx ethnicity had higher odds of making more linkages to HIV testing and HIV primary care at 24 months. Training providers in interprofessional collaboration principles and practice and basic HIV knowledge may improve the frequency of linkages to HIV care continuum services. [ABSTRACT FROM AUTHOR]

Background: Low levels of pre-exposure prophylaxis (PrEP) uptake continue among the most vulnerable (e.g., men who have sex with men) for HIV exposure in the USA. Providers of social and public health services ("psychosocial providers") can help improve this situation by educating patients about PrEP before linking them to primary care providers (PCPs).Objective: To identify predictors of psychosocial providers offering PrEP education to patients vulnerable to HIV infection by determining the frequency with which psychosocial providers offer PrEP education to patients.Design: Longitudinal overview of PrEP implementation in New York City.Participants: Psychosocial providers of HIV prevention and adjunct treatment services, such as medication adherence counseling in 34 community settings.Main Measures: Longitudinal survey data collected in 2014-2016 (baseline) and 2015-2017 (1-year follow-up) from a 5-year longitudinal repeated measures study. Logistic regression modeling tested associations between baseline psychosocial provider-level and organization-level characteristics and frequency of PrEP education at baseline and 1-year follow-up.Key Results: Out of 245 participants, the number of psychosocial providers offering PrEP education at least once in the past 6 months increased significantly from baseline (n = 127, 51.8%) to 1-year follow-up (n = 161, 65.7%). Participants with higher odds of offering PrEP education at baseline and at one1-year follow-up were more likely to have reported high levels of interprofessional collaboration (IPC) and were also more likely to have received formal HIV prevention training.Conclusions: Both IPC and HIV training are predictive of PrEP education, and this association was maintained over time. We recommend expanding educational outreach efforts to psychosocial providers to further improve PrEP education and also training in interprofessional collaboration. This is an important first step toward linking patients to PCPs who prescribe PrEP and may help improve PrEP uptake. [ABSTRACT FROM AUTHOR]

To adapt and validate a scale for measuring interprofessional collaboration in HIV prevention and care (IPC-HIV), primary survey data were collected (2012–2017) from 577 HIV service providers in 60 organizations in New York, New Jersey, and Michigan. Cross-sectional training data were used to develop the IPC-HIV scale. The model was validated by fitting the five-factor confirmatory factor-analysis model to a 30-item set. The scale measures five domains with reliable alpha coefficients: Interdependence, Professional Activities, Flexibility, Collective Ownership, and Reflection on Process. Correlations between subscales were significant (p <.05). The strongest correlation was between Reflection on Process and Collective Ownership subscale scores. Mean scores ranged lfrom 4.070 to 4.880, with the highest score for Flexibility across all locations. IPC-HIV is valid and reliable among HIV-prevention and care workers, and is recommended for examining the effect of IPC on patient access to HIV testing and primary care. [ABSTRACT FROM AUTHOR]

The science of implementing evidence-based interventions (EBIs) is being developed in social work and many other disciplines. Particular attention has been paid to whether, when, and how to de-implement an EBI if that intervention turns out to be harmful and/or a more effective/efficient EBI becomes available. Current research focuses on investigating how various environmental-, organizational-, provider-, and client-level factors influence the de-implementation process. Grounded in the HIV prevention field of inquiry and organizational theories, herein, we explore several issues that influence implementation and de-implementation and share key points for further investigation. Recommendations for future research are also discussed. [ABSTRACT FROM AUTHOR]

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In 2012, the Centers for Disease Control and Prevention (CDC) began to de‐emphasize and de‐implement multiple evidence‐based HIV prevention practices that had been around for 20 years, thus changing the scope of implementation across the globe. The authors provide evidence how existing interventions (e.g., CDC HIV interventions) may influence implementation of interventions that came after the program was discontinued. De‐implementation is an ecological event that influences, and is influenced by, many parts of a system, for instance, implementation of one type of intervention may influence the implementation of other interventions (biomedical and/or behavioral) after a long‐running program is discontinued. Researchers and policy makers ought to consider how de‐implementation of behavioral interventions is influenced by biomedical interventions mass‐produced by companies with lobbying power. The scientific study of de‐implementation will be inadequate without consideration of the political climate that surrounds de‐implementation of certain types of interventions and the promotion of more‐profitable ones. Highlights: Implementation of one type of intervention (behavioral) influences implementation of other types (biomedical) interventions.The surge of biomedical interventions influenced de‐implementation of behavioral interventions.Political climate and community exclusion from implementation decision‐making may lead to early de‐implementation. [ABSTRACT FROM AUTHOR]

There are many challenges to accessing PrEP and thus low uptake in the United States. This review (2007-2017) of PrEP implementation identified barriers to PrEP and interventions to match those barriers. The final set of articles (n = 47) included content on cognitive aspects of HIV service providers and individuals at risk for infection, reviews, and case studies. Cognitive barriers and interventions regarding patients and providers included knowledge, attitudes, and beliefs about PrEP. The “purview paradox” was identified as a key barrier—HIV specialists often do not see HIV-negative patients, while primary care physicians, who often see uninfected patients, are not trained to provide PrEP. Healthcare systems barriers included lack of communication about, funding for, and access to PrEP. The intersection between PrEP-stigma, HIV-stigma, transphobia, homophobia, and disparities across gender, racial, and ethnic groups were identified; but few interventions addressed these barriers. We recommend multilevel interventions targeting barriers at multiple socioecological domains. [ABSTRACT FROM AUTHOR]

Providers of social and public health services ("providers") often use HIV prevention strategies with substance-using clients to decrease HIV transmission and infection. This article examines factors that facilitate providers' use of select HIV-prevention strategies. Sample comprises 379 providers from 36 agencies in New York City.Outcomes: sexual risk assessments; risk reduction counseling; condom demonstration; and referrals to HIV testing.Predictors: training; job satisfaction; staff collaboration. The authors used multilevel logistic regression and linear multilevel models. HIV prevention training was associated with increased performance of each outcome. The odds of conducting several outcomes were higher for providers trained in evidence-based interventions. Staff collaboration and job satisfaction were associated with provision of multiple outcomes. This study shows training and collaboration/satisfaction as significantly influencing providers to use prevention strategies. Providers ought to be trained in multiple modalities, and agencies ought to prioritize collaborative environments that promote job satisfaction. [ABSTRACT FROM AUTHOR]

Health and social service practitioners have not readily incorporated research-based behavioral interventions in HIV prevention practice due to lack of awareness, lack of training, and challenges translating research findings into practice. Practitioners’ involvement in research is associated with their willingness to use research to guide practice. Likewise practitioners’ personal and organizational characteristics have been shown to be associated with use of research findings in practice. Factors associated with practitioners’ use of evidence-based interventions (EBIs) in HIV prevention, however are not well understood. While research involvement has been recommended to help practitioners overcome barriers to the use of EBIs, the types of research involvement that result in practitioners’ actual use of EBIs is not known. This is partly because most studies are either qualitative or quantitative and ignore the voices of practitioners, which can be best unearthed with qualitative research followed by survey research including larger numbers of participants. By using a mixed methods approach, this study fills this gap by showing associations between practitioners’ and organizational characteristics, specific areas of research involvement, and practitioners’ use of EBIs. The use of mixed methods was extremely helpful to integrate in-depth qualitative interview data from practitioners across 10 community-based agencies providing social and health services, with cross-sectional survey data from practitioners across 24 agencies in New York City. We used a sequential approach for data collection and a concurrent approach for data analysis, content analysis of in-depth interviews, and multivariate linear regression analysis. Practitioners who performed research tasks/procedures similar to their professional duties as well as their level of education, knowledge about EBIs, and their agency capacity were all positively associated with HIV evidence–based interventions. Training practitioners in research, engaging practitioners in research tasks that resemble their professional practices, and capacity building within organizations to foster academic-research partnerships could optimize practitioners’ use of EBIs. [ABSTRACT FROM AUTHOR]

Research is lacking about what makes or breaks collaboration between researchers and HIV services providers. This study identified factors that influence providers’ levels of willingness to collaborate in HIV prevention scientific research. Survey measures were grounded in in-depth interview data and included providers’ “willingness to collaborate,” and providers’ attitudes toward researchers’ availability, benefits of research, and agency preparedness. This survey was administered to 141 providers in New York City. A hierarchical regression model showed that providers’ perceptions of researchers’ availability (p < .05), research benefits (p < .001), and agency preparedness (p < .05) were associated with providers’ willingness to engage with researchers to purse HIV prevention research. Findings indicate that researchers need to be socially and professionally available, future HIV research should benefit providers and consumers, and policy makers should help agency settings develop human and financial resources in preparation for research. [ABSTRACT FROM PUBLISHER]

This study advances Community-based Participatory Research (CBPR) by presenting a set of triangulated procedures (steps and actions) that can facilitate participatory research in myriad international settings. By using procedural triangulation—the combination of specific steps and actions as the basis for the International Participatory Research Framework (IPRF)—our approach can improve the abilities of researchers and practitioners worldwide to systematize the development of research partnerships. The IPRF comprises four recursive steps: (i) contextualizing the host country; (ii) identifying collaborators in the host country; (iii) seeking advice and endorsement from gatekeepers and (iv) matching partners’ expertise, needs and interests. IPRF includes the following sets of recursive participatory actions: (A1) becoming familiar with local languages and culture; (A2) sharing power, ideas, influence and resources; (A3) gathering oral and written information about partners; (A4) establishing realistic expectations and (A5) resolving personal and professional differences. We show how these steps and actions were used recursively to build a partnership to study the roles of community health workers (CHWs) in Brazil's Family Health Program (PSF). The research conducted using IPRF focused on HIV prevention, and it included nearly 200 CHWs. By using the IPRF, our partnership achieved several participatory outcomes: community-defined research aims, capacity for future research and creation of new policies and programs. We engaged CHWs who requested that we study their training needs, and we engaged CHWs’ supervisors who used the data collected to modify CHW training. Data collected from CHWs will form the basis for a grant to test CHW training curricula. Researchers and community partners can now use the IPRF to build partnerships in different international contexts. By triangulating steps and actions, the IPRF advances knowledge about the use of CBPR methods/procedures for international health research. [ABSTRACT FROM PUBLISHER]

Integrating HIV prevention into substance abuse counselling is recommended to ameliorate the health outcomes of men who have sex with men. However, culture-based countertransferences (CBCs) may hamper this effort. Using a case illustration, this paper will explain the manifestation of CBCs held among substance abuse counsellors and how they hinder counsellors' work with men who have sex with men. The following CBCs will be explored: distancing, topic avoidance, heteronormativity, assumptions and denying client strengths. These CBCs allow counsellors to avoid discussions about sexual practices and curtail HIV prevention counselling, while undermining the counsellor-client relationship. Based on the empirical literature on HIV and substance abuse prevention with men who have sex with men, we provide recommendations to help counsellors overcome CBCs and integrate HIV prevention consistently with men who are in treatment for substance abuse. [ABSTRACT FROM AUTHOR]

Community collaboration in research may lead to better methods, results, and dissemination of interventions. Little systematic research has examined specific factors that influence community-based organizations (CBOs) to collaborate in public health research. There is an urgent need to advance knowledge on this topic so that together, researchers and CBOs can minimize barriers to collaboration. This study advances a CBOfocused characterization of collaboration in HIV-prevention research. By focusing on the perspectives of 20 key informants in 10 HIV-prevention CBOs, qualitative data revealed factors that influenced their collaborations in four domains: (a) Researchers' Characteristics (expertise, availability), (b) Collaborative Research Characteristics (ought to improve services and CBO infrastructure); (c) Community Partner-Researcher Relationships (resolving social and professional issues); and (d) Barriers to HIV-Prevention Research Collaboration (cultural and social disconnect between CBO and academia). To reduce barriers, researchers ought to enhance motivators that facilitate collaboration. To use the advantages of community-based research, prevention scientists and policy makers ought to embrace CBOs' characterization of what makes health research genuinely collaborative. [ABSTRACT FROM AUTHOR]

Male-to-female transgender individuals, or transgender women (TW), are at high risk for HIV infection and face multiple barriers to HIV care. Advocates agree that numerous factors need to be addressed concurrently to prevent HIV infection in TW, including primary health care. This article examines how a community-based clinic that offers free or low-cost care addresses the health care needs of TW. A total of 20 TW who attended a health care clinic dedicated to community-based health were interviewed regarding best practices for HIV prevention and primary care. In-depth interviews were conducted, transcribed, coded, and analyzed. Factors reported to be effective for HIV prevention and primary care included (a) access to health care in settings not dedicated to serving transgender and/or gay communities, (b) a friendly atmosphere and staff sensitivity, and (c) holistic care including hormone therapy. Community-based health care settings can be ideal locales for HIV prevention and primary care for TW. [Copyright &y& Elsevier]

Objectives: To determine what ethnic and racial minority women recommend as the best approaches to participatory health research in their communities. To achieve this goal, this study focused on HIV prevention research. Methods: In 2003, Seven African American and seven Latina women (ages 33 to 52), all members of an HIV Prevention Collaborative Board, participated in individual interviews, lasting about 90 minutes each. Participants discussed their involvement in participatory research, and made recommendations as to how health researchers might better engage their communities. Data were coded independently by two coders following standard procedure for content analysis. Results: Women's voices and expertise can help guide health-related research. This study shows that: (1) participatory HIV prevention research should be founded on trust and commitment, leading to social support: (2) research partners ought to come from diverse backgrounds and be knowledgeable about the community and willing to work on common objectives: and (3) collaborative partnerships ought to portray an image of strength and cohesion, and a clear articulation of the mission around a research project. Implications: To develop meaningful health research, researchers need to establish long-term ongoing relationships with community collaborators, including minority women from diverse backgrounds. Researchers ought to take a holistic approach working with communities, and ought to consider their research interests vis-à-vis in the community's needs. [ABSTRACT FROM AUTHOR]

As HIV prevention has become more focused on evidence based interventions and service provision for people living with HIV (PLH), providers are faced with challenges engaging and retaining PLH in prevention programs. Lessons learned by intervention facilitators may assist service providers address these challenges. To this end, 12 facilitators of a randomized behavioral intervention, designed to reduce sexual risk among PLH, participated in qualitative feedback groups regarding the challenges engaging and retaining participants and strategies used to overcome barriers. Qualitative methods revealed key components to tailoring prevention programs to successfully engage PLH: making interventions personally relevant, teaching skills that can be applied to participants' life contexts, providing support and consistency, and challenging resistance to sexual behavior change. [ABSTRACT FROM AUTHOR]

Involving low-income, ethnic minority families in lengthy HIV prevention programs can be challenging. Understanding the motivators and barriers to involvement may help researchers and practitioners design programs that can be used by populations most at risk for HIV exposure. The present study discusses motivators and barriers to involvement in the Collaborative HIV Prevention and Adolescent Mental Health Project (CHAMP), using data from a sample of 118 families that participated at varying levels in the twelve sessions of the program. Most participants chose motivators that reflect their perceptions of individual and/or family needs ("CHAMP might help me, mine, and other families"), and of characteristics of the program, such as CHAMP staff were friendly, CHAMP was fun. Among barriers to involvement, respondents expressed concerns about confidentiality, and about being judged by program staff. Respondents also reported experiencing many stressful events in their families (e.g., death and violence in the family) that may have been barriers to their involvement. Knowing these motivators and barriers, researchers and practitioners can enhance involvement in HIV prevention programs. [ABSTRACT FROM AUTHOR]

This study was designed to explore the experiences of urban parents in their role as Collaborative Board members as part of the CHAMP (Collaborative HIV prevention and Adolescent Mental health Project) Family Program Study. The CHAMP Collaborative Board is comprised of urban parents, representatives from schools and community- based agencies and university-based researchers and is charged with overseeing the design, delivery and testing of a family-based HIV prevention program for pre and early adolescent youth. The current qualitative study, guided by the Theory of Unified Behavior Change, is meant to elucidate: (1) pathways to involvement by urban parents; (2) benefits and costs of participating in this collaborative HIV prevention research effort; and (3) the role of social relationships in influencing initial and ongoing participation by parent participants. Twenty-nine parent Collaborative Board members were interviewed for this study. In-depth interviews were audio recorded and ranged from 30 to 90 minutes in length. Transcripts were coded and analyzed using NUD*IST, computerized software used for examining narratives. Findings include community parent members identifying social support and learning opportunities as major reasons for involvement with the Collaborative Board. Prior involvement with other community-based projects and knowledge of at least one other person on the Board also influenced members to join the Board and remain involved over time. Further, recommendations for future collaborative partnerships are made. Findings have direct implication for participatory HIV prevention research activities. [ABSTRACT FROM AUTHOR]

This article provides a description of a Community/University Collaborative Board, a formalized partnership between representatives from an inner-city community and university-based researchers. This Collaborative Board oversees a number of research projects focused on designing, delivering and testing family-based HIV prevention and mental health focused programs to elementary and junior high school age youth and their families. The Collaborative Board consists of urban parents, school staff members, representatives from community-based agencies and university-based researchers. One research project, the CHAMP (Collaborative HIV prevention and Adolescent Mental health Project) Family Program Study, an urban, family-based HIV prevention project will be used to illustrate how the Collaborative Board oversees a community-based research study. The process of establishing a Collaborative Board, recruiting members and developing subcommittees is described within this article. Examples of specific issues addressed by tile Collaborative Board within its subcommittees, Implementation, Finance, Welcome, Research, Grant writing, Curriculum, and Leadership, are detailed in this article along with lessons learned. [ABSTRACT FROM AUTHOR]

This study examines the relationship between contextual factors and attendance in a family-based HIV prevention program for low-income, urban, African-American women and their children. Participants' motivations to become involved, their concerns about discussing sex-related issues with their children, recruiters' perceptions of respondents' understanding of the program, and environmental stressors were examined. Participants' level of motivation and recruiters' success in improving respondents' understanding of the program were significant correlates of attendance. Stressors experienced by the family and concerns around talking with children about sex were not significantly associated with participation. Recommendations to enhance involvement in family-based HIV prevention programs are made. doi:10.1300/J137v15n02_16 [ABSTRACT FROM PUBLISHER]

This article introduces a user-friendly HIV prevention approach that can be incorporated in group work with adolescents. This approach consists of six systematic steps that account for adolescents' emotions, cognitive capabilities, and behavior changes within an HIV prevention framework. Step #1 explores clients' feelings about sexual activity; Step #2 uses their HIV knowledge as an engagement tool; Step #3 addresses barriers to having safer sex; Step #4 focuses on perceptions that might affect risk behaviors; Step #5 focuses on safer sex planning, and Step #6 focuses on referral-making. A practice illustration will show how to use the steps in a group process. [ABSTRACT FROM AUTHOR]