Leveraging video logs as a bridge to pre-exposure prophylaxis (PrEP) with tailored messaging to Black women and their healthcare providers in Texas

Abstract Achieving the nation’s Ending the HIV (EHE) Epidemic plan goals will require a significant increase in access to and uptake of pre-exposure prophylaxis (PrEP) among cisgender Black women (CBW). CBW continue to bear a disproportionate burden of new HIV cases through heterosexual contact, and are far less

likely to use PrEP. These factors magnify the health and social consequences of HIV to CBW. Although PrEP is available, CBW are among the least likely groups to use it, as only 2% of PrEP-eligible CBW have reported PrEP use, which amplifies a significant unmet prevention need. In order to increase PrEP use with eligible

CBW, researchers must identify strategies with capacity to build a secure bridge of connection between CBW and healthcare providers (HCPs) that can withstand formidable barriers to PrEP uptake (i.e. medical mistrust, HCP bias and stigma). Support by HCPs who are knowledgeable, willing, and comfortable with prescribing and

referring PrEP to CBW is necessary to increase PrEP initiation among CBW. The primary objective of this R34 proposal is to increase willingness for PrEP initiation and PrEP initiation among CBW and increase willingness to prescribe/refer PrEP to CBW among HCPs in Houston/Harris County, a high priority EHE jurisdiction.

We hypothesize that a video-log (vlog) series-based health communication intervention disseminated through community health centers (CHCs) and social media will increase PrEP initiation among CBW by supporting both CBW and HCPs in a way that will foster PrEP access and uptake. Specifically, the intervention will: 1) increase willingness to access and use PrEP among CBW and 2) increase willingness to

prescribe and refer PrEP to CBW among HCPs. Our team will explore two aims to 1) inform and develop health messages for Project ROLE with 2023 findings from focus groups with PrEP-eligible CBW and key informant interviews with HCPs providing care to CBW and 2) assess the feasibility, acceptability, and

preliminary impact of Project ROLE in two real-world settings with a pilot randomized controlled trial (RCT) and a social media campaign. The use of two ‘real-world’ settings to evaluate the feasibility and acceptability of this study is highly innovative. The proposed research is significant because it will connect CBW to PrEP while increasing HCP

willingness to prescribe and refer PrEP to them using health communication that can guide the development of subsequent vlog-based interventions to address the national EHE plan.