@article{ed2b2a353e5a4b4dbc363c5cc9571794,
title = "A Capacity-Strengthening Intervention to Support HIV Pre-exposure Prophylaxis (PrEP) Awareness-Building and Promotion by Frontline Harm Reduction Workers in Baltimore, Maryland: A Mixed Methods Evaluation",
abstract = "Pre-exposure prophylaxis (PrEP) is a promising but underutilized HIV prevention tool among people who inject drugs (PWID). We developed and piloted an intervention to bolster PrEP promotion competencies among frontline harm reduction workers (FHRW) serving PWID clients in Baltimore, Maryland. Between December 2021 and February 2022, we developed and facilitated four trainings, which included didactic and practice-based/role-playing components, with 37 FHRW from four organizations. FHRW completed three structured surveys (pretest, posttest, 6-week posttest) and in-depth interviews (n = 14) to measure changes in PrEP promotion competencies attributable to training participation. PrEP knowledge and self-efficacy increased significantly (p < 0.001) from pretest to posttest, sustained through 6-week posttest. The proportion of FHRW discussing PrEP with clients doubled during the evaluation period (30–67%, p = 0.006). Feeling empowered to discuss PrEP and provision of population-tailored PrEP information were facilitators of PrEP promotion, while limited client interaction frequency/duration, privacy/confidentiality concerns, and anticipated PrEP stigma by clients inhibited PrEP promotion. Our capacity-strengthening intervention successfully increased PrEP knowledge, self-efficacy, and promotion among FHRW, affirming the adaptability and feasibility of integrating our training toolkit into FHRW practice across implementation settings.",
keywords = "Doer/non-doer analysis, Formative research, HIV prevention, People who inject drugs, Pilot study, United States",
author = "Rosen, {Joseph G.} and Leanne Zhang and Danielle Pelaez and Park, {Ju Nyeong} and Glick, {Jennifer L.}",
note = "Funding Information: We thank all frontline harm reduction workers who participated in the PrEP Promotion Training and evaluation activities. Without their participation, engagement, and commitment to justice for marginalized populations, this work would not be possible. We wish to acknowledge Lyra Cooper, Praise Olatunde, and Teagan Toomre for scoping the published and grey literature for evidenced-based training curricula and best-practices that informed our PrEP Promotion Training. We also thank Aimee Huang and Megan Nguyen for participating in mock training sessions and for their invaluable feedback to the training content and delivery. Lastly, we acknowledge Dr. Sheree Schwartz for her guidance as we designed the study and developed its data collection instruments. Funding Information: This work was supported by the Johns Hopkins University Center for AIDS Research, an NIH-funded program (Grant No. P30AI094189). JGR was supported by a predoctoral training grant from the National Institute of Mental Health (Grant No. F31MH126796). JNP was supported by a grant from the National Institute of General Medical Sciences (Grant No. P20GM125507). JLG was supported in part by a faculty development grant from Johns Hopkins University. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Publisher Copyright: {\textcopyright} 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.",
year = "2023",
doi = "10.1007/s10461-022-03971-4",
language = "English (US)",
journal = "AIDS and behavior",
issn = "1090-7165",
publisher = "Springer New York",
}