Grant: DRA: Canada Impact+ Research Training Awards - Doctoral

Rationale: HIV self-testing (HIVST) and HIV pre-exposure prophylaxis (PrEP) are unevenly and insufficiently distributed across Canada. The I'm Ready platform effectively reaches first-time testers and penetrates communities that do not routinely interact with traditional services, thereby creating a critical opportunity to connect individuals with a non-reactive HIVST result to PrEP. The key to unlocking this opportunity is to design a linkage pathway between I'm Ready and a virtual PrEP partner that is trusted, protects privacy, culturally appropriate, and equity targeting for priority populations. Methods and Analysis: This study uses quantitative and qualitative research with three integrated components. (1) Collaborative design: Involves the inclusion of community partners in specifying a provisional programme theory and defining a linkage strategy alongside a measurement plan; (ii) Experimental evaluation: Linkage effects will be assessed using a phased rollout across four provinces. Data collection will include in-app surveys and routine app logs. The primary endpoint is click-through to virtual PrEP within 180 days of a non-reactive result; (iii) Process evaluation: A qualitative component will entail interviews with app users and intervention partners to explain heterogeneity, identify constraints, and refine the programme theory. Expected impact: The research will produce: (1) a collaboratively developed, scalable, theory-informed linkage strategy for digital HIVST-to-PrEP pathways; (2) an empirically refined, collectively informed implementation theory for digital health linkage in stigma-sensitive settings; and (3) policy-ready evidence to strengthen equitable, virtual prevention efforts in Canada, with insights applicable to global contexts.