Journal Article

Centering PrEP: Utilizing ADAPT-ITT to inform group PrEP care for sex workers in Chicago

Crooks, Natasha, Sherman, Susan G., Abboud, Sarah, Patil, Crystal L., Neely, Jennifer, Johnson, Amy K., Stamps, Jahari, Barrow, Janelli, Zemlak, Jessica, Singer, Randi Beth, Bruce, Douglas, Matthews, Alicia K., Green, Noel

2024

Overview

Background Sex workers, those who trade sex for monetary or nonmonetary items, experience high rates of HIV transmission but have not been adequately included in HIV prevention and Pre-Exposure Prophylaxis (PrEP) adherence program development research. Community-empowered (C.E.) approaches have been the most successful at reducing HIV transmission among sex workers. Centering Healthcare (Centering) is a C.E. model proven to improve health outcomes and reduce health disparities in other populations, such as pregnant women, people with diabetes, and sickle cell disease. However, no research exists to determine if Centering can be adapted to meet the unique HIV prevention needs of sex workers. Objective We aim to explain the process by which we collaboratively and iteratively adapted Centering to meet the HIV prevention and PrEP retention needs of sex workers. Methods We utilized the Assessment, Decision, Adaptation, Production, Topical Experts, Integration, Training, Testing (ADAPT-ITT) framework, a model for adapting evidence-based interventions. We applied phases one through six of the ADAPT-ITT framework (Assessment, Decision, Adaptation, Production, Topical Experts, Integration) to the design to address the distinct HIV prevention needs of sex workers in Chicago. Study outcomes corresponded to each phase of the ADAPT-ITT framework. Data used for adaptation emerged from collaborative stakeholder meetings, individual interviews ( n  = 36) and focus groups ( n  = 8) with current and former sex workers, and individual interviews with care providers ( n  = 8). In collaboration with our community advisory board, we used a collaborative and iterative analytical process to co-produce a culturally adapted 3-session facilitator's guide for the Centering Pre-exposure Prophylaxis (C-PrEP +) group healthcare model. Results The ADAPT-ITT framework offered structure and facilitated this community-empowered innovative adaptation of Centering Healthcare. This process culminated with a facilitator's guide and associated materials ready for pilot testing. Conclusions In direct alignment with community empowerment, we followed the ADAPT-ITT framework, phases 1–6, to iteratively adapt Centering Healthcare to suit the stated HIV Prevention and PrEP care needs of sex workers in Chicago. The study represents the first time Centering has been adapted to suit the HIV prevention and PrEP care needs of sex workers. Addressing a gap in HIV prevention care for sex workers, Centering PrEP harnesses the power of community as it is an iteratively adapted model that can be piloted and replicated regionally, nationally, and internationally.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: ADAPT-ITT / Adaptation / Analysis / Anti-HIV Agents - therapeutic use / Antiretroviral drugs / Biostatistics / Chicago / Cisgender / Clinical outcomes / Collaboration / Community / community empoerment / Community health services / Community power / Community research / Criminalization / Delivery of Health Care / Demographic aspects / Diabetes / Diabetes mellitus / Diabetics / Disease prevention / Disease transmission / Domestic violence / Empowerment / Environmental Health / Epidemiology / Evaluation / Experts / Female / Focus groups / Frame analysis / Grammatical aspect / group care / Health aspects / Health care / Health care reform / Health disparities / Health services / Health status / HIV / HIV (Viruses) / HIV infection / HIV Infections - drug therapy / HIV Infections - prevention & control / Human immunodeficiency virus / Humans / Intervention / Interviews / Iterative methods / Management / Marginalized groups / Medical personnel / Medical research / Medicine / Medicine & Public Health / Medicine, Experimental / Needs / Pre-Exposure Prophylaxis / Pregnancy / Pregnant women / PrEP / Prevention / Prevention programs / Preventive medicine / Production / Prostitutes / Prostitution / Public Health / Risk factors / Safety and security measures / Sex industry / Sex oriented businesses / sex work / Sex Workers / Sexually transmitted diseases / Sickle cell anemia / Sickle cell disease / Social networks / STD / Vaccine / Women / Womens health / Word of mouth advertising / Workers