Despite the substantial declines in HIV transmission achieved over the past decade, the full benefits of available tools and interventions have yet to be realized in youth. This disparity is in large part due to the inadequate implementation of efficacious interventions tailored in partnership with youth. The proposed approach to optimizing intervention implementation is the integration of data science, implementation science, and the science of engagement into a Youth Learning Health Community (Y-LHC). Florida is suffering from a severe HIV epidemic, and ranks second in the number of End the Epidemic jurisdictions (n=7). In Florida, as well as nationally, emerging adults continue to be overrepresented among new HIV cases in youth. In North Florida, considered the Deep South, there are 10 counties with high HIV prevalence but they have much fewer resources and much less research activity than counties in South and Central Florida. Thus, addressing implementation of evidence-based interventions along the youth prevention continuum in North Florida is highly significant. Our proposed approach will a model of translational behavioral science with with community-engaged systems science to develop a Y-LHC in North Florida using data from OneFlorida+ Data Trust, a clinical research consortium of 11 health systems in Florida. Aim 1 is to define implementation strategies using community-engaged system science methods for youth in North Florida (R21 phase). Aim 2 is to conduct simulations of selected strategies to refine for feasibility and greatest impact (R21 phase) Aim 3 is to conduct proof of concept (POC) study of collaboratively selected strategies on feasible, pragmatic outcome measures (R33) using a pre-post mixed methods approach with additional simulations of strategy effect. This project will not only pave the way for multisite pragmatic trials to address the Diagnose and Prevent pillars of the End the Epidemic initiative for youth as a key population but will also test a transformative framework for translating community-engaged systems science into new implementation strategies with pragmatic outcomes.

This project will use engage the community to understand what is needed to improve HIV testing and HIV prevention in young people in North Florida. It will use new methods and publicly available data to inform future studies to end the epidemic by improving testing and prevention.