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Effective Interventions

PrEP and Community-Based Organizations

Community-Based Organizations

Delivery of PrEP in the United States includes a system of prevention and support services, or the PrEP care system, that contributes to making PrEP available, accessible, and acceptable.

Non-clinical, community-based organizations (CBOs) play an important role in the PrEP care system.

CBOs can provide the following key services in support of PrEP:

  • Promotion and education;
  • Engagement, identification, and recruitment;
  • Evidence based interventions supporting PrEP uptake;
  • Navigation; and
  • Directories of health and prevention services.

Promotion and Education:

CBOs have an important role in promoting PrEP and providing education on PrEP to populations in need. Individualized education on PrEP should be routine and integrated into community-based prevention services, such as outreach and testing services for HIV and sexually transmitted infections. Community-wide education on PrEP can occur in a variety of complementary ways, including:

  • Visuals, brochures, and pamphlets;
  • Media campaigns, including the use of social media;
  • Radio and television public service announcements; and
  • Partnerships with community members, key stakeholders, and peers to build trust and credibility.

CDC has available educational materials and campaign resources.

Engagement, Identification, and Recruitment

Persons at high risk for HIV acquisition can be identified for PrEP clinical services through outreach, testing, and other program contact, services, and interventions. Those who are at highest risk of HIV acquisition often encounter barriers, such as stigma, medical mistrust, and perceived payment barriers, that prevent them from receiving health services. Targeted recruitment and other PrEP service efforts can be used to reach those who are at highest risk and traditionally underserved by HIV prevention. Refer to populations in need in the resource section for more information.

In addition to education about PrEP, candidates may need motivation to use it. Use of motivational interviewing or counseling may be beneficial in influencing individuals to accept PrEP as a prevention method.

Evidence-Based Interventions Supporting PrEP Uptake:

There are a number of appropriate high-impact prevention, or HIP, intervention models for promoting PrEP.

PROMISE for HIP promotes PrEP by creating and distributing community- and population-specific role model stories to spread educational messages and modeling community member experiences and endorsements.

Popular Opinion Leader focuses on identifying, recruiting, and supporting opinion leaders (individuals who have influence in and across populations) to endorse an intervention like PrEP so that it becomes a prevention innovation through social network
acceptance and uptake. This approach is similar to “viral marketing” where marketing occurs within social networks. Popular Opinion Leader focuses on the influence of friends on opinions about a prevention practice, like PrEP.

d-up: Defend Yourself! is targeted to black gay, bisexual, and other men who have sex with men (MSM). The d-up: Defend Yourself! intervention includes skills-building for coping with community and individual-level stigma.

Mpowerment brings young MSM together into a dedicated community space, and empowers them to educate, organize, support, and promote innovations like PrEP.

Navigation:

Navigation for PrEP includes identifying and linking persons in need of PrEP to healthcare systems, assisting with health insurance, identifying and reducing barriers to care, and tailoring education to the client to influence his or her health-related attitudes and behaviors.

CBOs are often in a position to identify and guide PrEP candidates because they work with persons in need of PrEP during existing services delivery. Integrating PrEP education and referrals into program services is an effective way to promote PrEP to those who are likely candidates. Examples include sexually transmitted infection services, HIV testing services, and partner services.

CBOs that do not provide clinical services should develop working relationships with PrEP clinicians to facilitate linkage of community members to PrEP services. Clinical programs may also want to involve staff from CBOs to help to manage PrEP patients. Working relationships with behavioral health clinics, substance abuse treatment clinics, and other clinical service providers may be beneficial in proving services to persons in need of PrEP.

PrEP candidates may also need assistance in navigating payment coverage, transportation, communication with clinicians, among other services. Developing a comprehensive directory of available, accessible, and acceptable services can help CBOs refer individuals to these services.

Directories of Health Services Including PrEP:

A comprehensive directory of available, accessible, and acceptable services should support navigation and guidance of clients. The local health department or other local community-based organizations may have created such a directory. Jurisdictional planning groups routinely create and maintain resource directories. If none are available in your jurisdiction, you may want to create a directory for serving your PrEP clients. Providers in local directories should also be registered at www.PrEPlocator.org, an online PrEP provider resource maintained by CDC’s National Prevention Information Network. CBOs may also need to have memoranda of agreement with service providers to facilitate engaging clients with their services.

CBA Request Information System (CRIS) is a web-based application that allows CDCfunded and other organizations to request CBA services. It also serves as a tool to monitor, track, and follow-up on CBA Requests. A user ID and password are required to access this CDC-sponsored web application.

HIP Project Contact Info:    Phone: 1-(866) 532-9565 or (240) 645-1756    E-mail: interventions@dlhcorp.com
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