# PrEP Connect: Bridging HIV Testing to PrEP Screening and Uptake

> **NIH NIH R21** · FAMILY HEALTH INTERNATIONAL · 2020 · $197,029

## Abstract

PROJECT SUMMARY
This proposal responds to PA-19-050 Engaging Men in HIV Testing, Prevention, and Care and to NOT-MD-19-
001 Notice of Special Interest in Research on the Health of Sexual and Gender Minority (SGM) Populations.
HIV testing is an essential first step in reducing HIV transmission rates, but the prevention counseling
component has been significantly reduced in recent years and has not incorporated validated PrEP referral
processes as standard of care. For those most in need of prevention services additional barriers include the
cumulative impact of experiences of racial discrimination and social stigma against SGMs compounded with
persistent HIV stigma. The impact of these forces on HIV testing and prevention are widely acknowledged but
remain extremely difficult to intervene upon. This exploratory study combines an innovative participatory
approach and intersectional stigma framework to understand how black SGM in a Southern city experience
HIV/STI testing and PrEP referral. We build on existing simulated client/patient approaches to elicit, observe,
and interpret interactional behaviors in health settings to capture black SGM experiences in close to real time
and proximity to the environments where they receive testing and PrEP services. The goal is to understand the
subjective experience of the simulated client/patient, not conduct an objective evaluation of the provider. In Aim
1 we will (a) recruit and train eight black SGM to perform in the role of a simulated client/patient accessing
HIV/STI testing and PrEP services and (b) conduct simulated walk-through exercises with providers to
document and describe their standard mode of service delivery and negotiate agreements for how simulated
clients/patients will access their services. In Aim 2 simulated clients/patients will complete structured surveys
immediately before and after each engagement with a provider (n=32 events) followed by a qualitative de-brief
interview. We will then conduct in-depth interviews with providers to understand their perspectives on the types
of experiences reported. Qualitative coding and structured survey data will be combined using a matrix-based
applied thematic analysis approach, including use of frequency tables and visualization techniques to compare
and contrast black SGM intersectional experiences of stigma, discrimination, empowerment, and confirmation.
Aim 3 centers on participatory intervention mapping with stakeholders including black SGM and providers to
review the range of prevention experiences and collaboratively identify ways to improve (a) the referral/intake
experience, (b) the capacity of providers to identify clients likely to benefit from PrEP, and (c) linkage to and
uptake of PrEP by clients at highest risk. Findings will be of immediate value for local quality improvement in
services, inform the expansion of HIV prevention services more broadly in North Carolina, and inform
development of an equity-based provider training interve...

## Key facts

- **NIH application ID:** 10079952
- **Project number:** 1R21MH124579-01A1
- **Recipient organization:** FAMILY HEALTH INTERNATIONAL
- **Principal Investigator:** Kathleen M MacQueen
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $197,029
- **Award type:** 1
- **Project period:** 2020-09-01 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10079952

## Citation

> US National Institutes of Health, RePORTER application 10079952, PrEP Connect: Bridging HIV Testing to PrEP Screening and Uptake (1R21MH124579-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10079952. Licensed CC0.

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