Applying Behavioral Economic Incentives to Support Implementation of PrEP in a Trans Community Center

NIH RePORTER · NIH · P30 · $270,614 · view on reporter.nih.gov ↗

Abstract

PROJECT ABSTRACT HIV prevalence is high among transgender and nonbinary (TGNB) individuals in the Ending the HIV Epidemic (EHE) priority jurisdiction of Los Angeles County (LAC). HIV pre-exposure prophylaxis (PrEP) is an evidence- based innovation and part of both the local LAC HIV Prevention Plan and the EHE `Prevent' pillar for individuals with elevated risk for HIV exposure such as TGNB. However, uptake of PrEP remains low among TGNB individuals in LAC, especially among TGNB individuals of color. Low uptake and persistence have been due to numerous structural and economic barriers that have been previously identified in multiple studies as well as by our team in LAC. Currently, there is high need to identify and test multilevel implementation strategies to improve and accelerate PrEP uptake and persistence among at-risk TGNB individuals. Our uniquely qualified community- academic collaborative research team proposes a sequential cohort deign19 where three cohorts of (n=25) TGNB clients will be recruited from a trans community center currently implementing a community-led PrEP program to collect preliminary data on the acceptability, feasibility, and preliminary effects of three discrete behavioral economic approaches for encouraging implementation and engagement with the a community-led PrEP program. These three approaches Individual identity Behavioral Economic Incentives (IBEI), Community-based Behavioral Economic Incentives (CBEI), and Staff-based Behavioral Economic Incentives (SBEI). Identity economics, a type of BE, describes how economic actions are the result of the combination of monetary incentives and the individual's identity or self-concept. This study will be the first test three discrete behavioral economic strategies for implementing PrEP services in a Trans Community Center. The proposed supplement will leverage the parent study PrEP Well, a 3-year California HIV/AIDS Research Program-funded implementation science grant (CHRP: H21IS3484) to bring comprehensive and gender-affirming PrEP services to scale in a first-of-its-kind transgender community center, TWC. Currently entering the second project year, PrEP Well has fostered a strong community-academic research collaboration where we will be assessing targeted strategies for implementing PrEP at TWC. Through our interviews and focus groups conducted during the first year of the PrEP Well project with TWC staff, clients, community advisory board members, and other key stakeholders it has become clear that providing behavioral economic approaches for PrEP uptake and persistence that may simultaneously help address some of the myriad competing needs of TWC clients is currently of high priority.

Key facts

NIH application ID
10600680
Project number
3P30MH058107-26S5
Recipient
UNIVERSITY OF CALIFORNIA LOS ANGELES
Principal Investigator
Steven J Shoptaw
Activity code
P30
Funding institute
NIH
Fiscal year
2022
Award amount
$270,614
Award type
3
Project period
1997-09-30 → 2026-12-31