Grant: Operating Grant - HIV/AIDS CBR Program - General

African, Caribbean and Canadian Black (ACB) people in Ontario are disproportionately affected by the HIV epidemic. ACB people represent 4.7% of the Ontario population, yet account for 30% of the HIV prevalence and 27% of new infections, despite the availability of highly effective HIV prevention medication - HIV pre-exposure prophylaxis (PrEP) that was approved by Health Canada in 2016 which can prevent new infections. PrEP is a highly effective HIV-risk reduction strategy and a critical part of a comprehensive approach to HIV prevention. However, data shows that the use of PrEP among PrEP-eligible ACB people in Ontario is very low. The overall goal of this research program is to identify and address (reduce) the barriers to uptake and use of PrEP, increase the proportion of eligible ACB people starting and retained on PrEP, reduce the incidence of new HIV infections, and ultimately slow the trajectory of HIV infection in ACB communities in Ontario and in Canada. In collaboration with two Black serving community organizations and other community service providers, this work will include two main phases, the first is the use of focus groups and semi-structured interviews with PrEP-eligible Blacks to identify the specific structural barriers affecting uptake and use of PrEP. We will then use these findings in the 2nd phase to adapt and scale an HIV PrEP implementation strategy - Client-Centered Care Coordination (C4) in a community health center and an AIDS Service Organization to significantly improve the uptake and use of PrEP among PrEP-eligible people from ACB communities. Lessons learned from this project will enable us to scale up this intervention in other ACB communities in Canada to reach zero new HIV infections.