PROJECT ABSTRACT: HIV disproportionately affects Latino men who have sex with men (LMSM), especially immigrants. The CDC estimates the lifetime HIV risk is 1 in 5 for LMSM compared to 1 in 11 for White MSM. Pre-Exposure Prophylaxis (PrEP) is an evidence-based intervention highly effective in preventing HIV acquisition, with the potential to reduce the number of new HIV infections among immigrant LMSM. However, implementation of interventions such as PrEP with immigrant LMSM may not reach their full potential due to challenges and barriers in delivery. As such, the development of appropriate and feasible implementation strategies holds the potential to improve PrEP delivery to this population. The goal of this planning project is to work within the “Exploration and Preparation” phases of the Exploration, Preparation, Implementation, Sustainment (EPIS) implementation framework to develop strategies to address inequities in delivery of PrEP to immigrant LMSM in Los Angeles County (LAC). This project focuses on the Prevent Pillar of the national Ending the HIV Epidemic (EHE) initiative and aligns with LAC's EHE plan to facilitate PrEP scale up efforts and reduce barriers to access and continuation. As a first step in this project, we will use an intersectional framework to examine the interplay between stigmatizing identities (i.e., Latinx ethnicity, gay identity, immigrant status) and structures (lack of access to healthcare, institutionalized homophobia and stigma) to understand the experiences of immigrant LMSM in accessing health care and HIV prevention services such as PrEP. In our second step, we will use community-engaged approach to develop implementation strategies to optimize delivery to and adoption of PrEP among immigrant LMSM. More specifically, we will use a concept mapping methodology to work with a panel of key stakeholders with expertise, knowledge and or experience working with immigrant Latino MSM (i.e., service providers, HIV planning body members, community advocates) to collectively address barriers to PrEP delivery to this population. Through the concept mapping process, the panel will conceptualize and define multiple implementation strategies (e.g., new PrEP support services, provider training, and change in practice/policy) to enhance PrEP delivery to the population. The panel will also The expected outcomes include a conceptual model and compilation of stakeholder- and community-generated implementation strategies to enhance access to and delivery of PrEP to immigrant LMSM in LA County. We will share the findings with our local HIV planning body and community partners for future implementation. rate the relative importance and feasibility of the implementation strategies to improve PrEP delivery.

Implementation of evidence-based interventions such as PrEP with immigrant Latino men who have sex with men (LMSM) may not reach their full potential due to challenges and barriers in delivery. As such, there is an urgent need to develop appropriate, feasible and sustainable implementation strategies to improve PrEP delivery to this population. The goal of this planning project is to work within the “Exploration and Preparation” phases of the Exploration, Preparation, Implementation, Sustainment (EPIS) implementation framework to develop strategies to address inequities in delivery of PrEP to immigrant LMSM in Los Angeles County.