Harkness Audrey, Weinstein Elliott R, Lozano Alyssa, Mayo Daniel, Doblecki-Lewis Susanne, Rodriguez Diaz Carlos E, Brown C Hendricks, Prado Guillermo, Safren Steven A
University of Miami, Department of Public Health Sciences.
University of Miami, Department of Psychology.
Implement Res Pract. 2022;3. doi: 10.1177/26334895221096293. Epub 2022 Jun 2.
Latino men who have sex with men (LMSM) experience HIV and behavioral health disparities. Yet, evidence-based interventions, such as pre-exposure prophylaxis (PrEP) and behavioral health treatments, have not been equitably scaled up to meet LMSM needs. To address quality of life and the public health importance of HIV prevention, implementation strategies to equitably scale up these interventions to LMSM need to be developed. This study identifies themes for developing culturally grounded implementation strategies to increase uptake of evidence-based HIV prevention and behavioral health treatments among LMSM.
Participants included 13 LMSM and 12 stakeholders in Miami, an HIV epicenter. Feedback regarding the content, design, and format of an implementation strategy to scale up HIV-prevention and behavioral health services to LMSM were collected via focus groups (N=3) and individual interviews (N=3). Themes were inductively identified across the Health Equity Implementation Framework (HEIF) domains.
Analyses revealed five higher order themes regarding the design, content, and format of the implementation strategy: cultural context, relationships and networks, navigation of health information and systems, resources and models of service delivery, and motivation to engage. Themes were applicable across HEIF domains, meaning that the same theme could have implications for both the development and implementation of the implementation strategy.
Findings highlight the importance of addressing culturally specific factors, leveraging relational networks, facilitating navigation of health systems, tailoring to available resources, and building consumer and implementer motivation in order to refine an implementation strategy for reducing mental health burden and achieving HIV health equity among LMSM.
与男性发生性关系的拉丁裔男性(LMSM)面临着艾滋病毒和行为健康方面的差异。然而,诸如暴露前预防(PrEP)和行为健康治疗等循证干预措施尚未得到公平推广,以满足LMSM的需求。为了解决生活质量问题以及艾滋病毒预防的公共卫生重要性,需要制定将这些干预措施公平推广至LMSM的实施策略。本研究确定了一些主题,用于制定基于文化的实施策略,以提高LMSM对循证艾滋病毒预防和行为健康治疗的接受度。
参与者包括迈阿密(一个艾滋病毒高发地区)的13名LMSM和12名利益相关者。通过焦点小组(N = 3)和个人访谈(N = 3)收集了有关将艾滋病毒预防和行为健康服务推广至LMSM的实施策略的内容、设计和形式的反馈。在健康公平实施框架(HEIF)各领域中归纳确定主题。
分析揭示了有关实施策略的设计、内容和形式的五个高阶主题:文化背景、关系和网络、健康信息与系统的导航、资源与服务提供模式以及参与动机。这些主题适用于HEIF的各个领域,这意味着同一主题可能对实施策略的制定和实施都有影响。
研究结果强调了应对文化特定因素、利用关系网络、促进健康系统导航、根据可用资源进行调整以及激发消费者和实施者动机的重要性,以便完善一项实施策略,减轻LMSM的心理健康负担并实现艾滋病毒健康公平。